PI Name: / Protocol #:

Appendix H. Exemption of Standards Request

Refer to Exemptions from Standards of Carefor further guidance when completing this appendix.

An exemptionoccurs when deviating from the federal regulations and University policies and guidelines regarding the care and use of vertebrate animals in testing, research and educational activities. A request for an exemption must be submitted to the IACUC for review.

What is the purpose of an exemption?

To justify, based on scientific necessity or, in the case of husbandry, veterinary assessment, any deviations from the Animal Welfare Act, the Guide, and other regulations in accordance to our IACUC Policy for Exemptions from Standards of Care.

A consultation with an ACO veterinarian is required prior to completing this form.

So, what does the IACUC expect?

  • A detailed description of the deviations from the Standards of Care outlined in the Guide. Include the time period for how long this will apply to a given animal.
  • An estimate of the numbers of animals which will be covered by the exemption. If circumstances require a change in this number, an amendment to change this number will need to be submitted for IACUC approval.
  • A strong scientific justification for why no existing standard of care is acceptable; or in the case of husbandry considerations, an unequivocal veterinary assessment of the appropriateness of the proposed standards of care. Note that mere convenience or cost alone does not provide adequate scientific justification.

Note that the exemption will be observed every 6 months during the Animal Facility Inspection, and reviewed annual with the annual renewal of the protocol.

The IACUC approved exemptions must be posted in the animal facility for as long as the exemption is active.

Veterinarian Contacts:

Dr. David Brammer, Executive Director ACO (713) 743-9164

Dr. Angelina Williams, Clinical Veterinarian(713) 743-2971

Dr. Terry Blasdel, IACUC Veterinarian(713) 743-9191

IACUC Office Contacts:

Sarah Viranda, IACUC Coordinator(713) 743-9252

  1. Location

Indicate the facility, building, and room number in which the exemption will take place:

  1. Animal Use

For each animal or study group requiring this exemption, identify the specific group and indicate the number of animals involved:

  1. Exemption

Select which standard or guide you wish to have an exemption:

Food/water control (See Food and Water Restriction Policy)

The exercise plan for dogs

The environmental enrichment plan for nonhuman primates

Use of an animal in more than one major survival surgery

Maintaining animals at temperatures or humidities outside the ranges specified by standards

Cleaning or sanitation requirements

Diurnal light cycle requirement

Space requirement (including innovative enclosures and metabolic cages)

Other: (e.g. federal, state, UH ACO guidelines)

  1. Justification for Exemption

Explain why you need to deviate from the standards and derive the duration of the exemption (e.g. weeks, year, permanent)

  1. Distress

How is this experiment expected to increase stress in the animal and what are the plans to relieve this stress?

  1. Statement of Agreement

I have acquainted myself with the Federal Regulation and University Policies regarding the care and use of vertebrate animals in testing, research and education activities. I am requesting an IACUC exemption for the standards or guidelines listed above. If the exemption is granted, I am aware that is exemption may be reported to the USDA and/or OLAW as required by law.

Signature of Principal Investigator: / Date:
DOR.ORPCC.A.0H - IACUC NP Appx H Exemption of Standards
Form updated March2015 / 1 of 2