Change in Principal Investigator Request Form

CHANGE IN PRINCIPAL INVESTIGATOR REQUEST FORM

Note: All personnel listed on an IACUC protocol including the PI are required to comply with the IACUC Policy on Requirements for Personnel Working with IACUC-Covered Animals.

Protocol Number & Title
CURRENT Principal Investigator: / Remain on protocol? / Yes No
NEW Principal Investigator: / Degree(s):
Phone #/E-mail Address: / Academic Position:
Years of experience with protocol procedures:
Years of experience with species included in protocol:
If not a Tufts University or Tufts Medical Center Employee, provide justification for change in PI:

PRINCIPAL INVESTIGATOR ASSURANCE OF COMPLIANCE

As the individual responsible for this project, I confirm the following:

The information contained in this protocol is true and accurate, and to the best of my knowledge conforms to Tufts University/Tufts Medical Center IACUC, NIH, USDA, and MDPH policies on the use of animals in research and teaching.

I have considered alternatives to the biological models used in this project and have found these other methods unacceptable on scientific or educational grounds.

I certify that I have determined that the research proposed herein is not unnecessarily duplicative of previously reported research.

I accept responsibility for ensuring that all personnel involved in this project will be trained regarding any potential chemical hazards, relevant safety practices, and emergency procedures. I confirm that the relevant DLAM/LAMS/CBU Safety Plan(s) will be followed.

I accept responsibility for ensuring that all personnel involved in this project will be trained regarding any potential biological hazards, relevant safety practices, and emergency procedures. If applicable, I confirm that all relevant Institutional Biosafety Committee requirements will be followed.

All personnel involved in this project will be added to the protocol using a Supplement P. All personnel involved will agree to participate in the study and will be aware of the approved procedures. All individuals involved will be instructed in the humane care, handling, and use of animals, and I will review their qualifications.

No change will be made to procedures, care or housing without prior written notification to and approval by the Institutional Animal Care and Use Committee (IACUC).

I understand that it is non-compliant to release an IACUC approval date without documentation of a congruency comparison conducted by the IACUC Office. For more information, please see the Policy on Requiring a Congruency Comparison Prior to Release of IACUC Approval Dates.

I accept responsibility for complying with Material Transfer Agreement requirements. For more information, please see Material Transfer guidance on the Tufts Tech Transfer website.

I understand that failure to comply with IACUC policies and procedures will jeopardize Tufts University’s or Tufts University-Tufts Medical Center’s Animal Welfare Assurances on file with the NIH, and may lead to revocation of my privileges to conduct animal research at this institution.

Electronic Signature of New Principal Investigator / Date

By typing your name you are submitting an electronic signature that confirms your understanding and adherence to the above statements and IACUC policies. This is considered legal documentation and confirmation of your agreement to execute all activities as approved.

July 2018 version