Mouse Sperm Cryopreservation Request

PI: ______Date Submitted: ______

Mouse line / strain name: ______

Contact person: ______

Contact person info:

Phone #1: ______Phone #2: ______

FAX: ______Pager: ______

Email:______

SERVICE DESCRIPTION:The MMC will collect and vitrify (cryopreserve) sperm from 2 donor males.

- You must supply the MMC(Mouse Model Core) with at 2 proven stud male mice possessing the mutation or transgene of interest. The viability of the sperm will vary depending on the age, strain background, and fertility of the donor stud males you provide the MMC.

- MMC will perform one QA/QC test thaw for viability per stud male collected. A “control” vial containing 40ul vitrified sperm will be set aside from the rest of the “banked” sperm to be used for the viability test. The viability test will consist of thawing and rehydrating the “control” sperm, and incubating them in culture medium to check motility and survival rate.

- Frozen Sperm Delivery and Storage Agreement: The MMC will make arrangements ahead of time to so that your laboratory will be ready to receive the frozen sperm on the day of the cryopreservation session.

- ACS can also store the frozen sperm in their liquid nitrogen tank for a monthly fee. It is recommended that frozen sperm be stored in two locations to ensure availability in the event of a failure of one of the storage tanks.

- Before service, you will need to provide some information about your mouse strain and some administrative details. Please fill out this form and then contact the Mouse Models Core Facility. The manager will arrange a meeting with you to transfer the mice, and to review your information.

- All services are performed in the order received and are kept confidential.

Questions and Contact info for this service:

The fee for this service, as well as the electronic version of this form, can be found under the Fees section of MyACS after logging into the following website:

Line background: ______

BILLING INFORMATION

PI: ______

The following Chart Field Stream information must be provided for billing:

* Department ID:

* Fund Code:

* Program Code:

Source of Fund:

Project Code:

Flex Code:

(* items are required)

If the work will be paid for with funds from outside of the University of Florida, they must be paid by check in advance to the ACS Business Office; (352) 392-0526.

Before initiation of the project, we will need an Institutional Animal Care and Use (IACUC) protocol number for your project, and a location to which to deliver the sperm. The IACUC protocol need only be for analysis or processing of the sperm - the Core Facility has IACUC approval for the procedures used to cryopreserve the sperm. MMC will deliver all “banked” frozen sperm from a session on the same day the service was performed to the Lab’s designated LN2 storage tank.

By signing below, the PI agrees to not hold Animal Care Services accountable, nor liable for the disposition and/or loss of any frozen sperm upon transfer to the Lab’s LN2 storage tank. Copies of the specific freezing and thawing protocols used will be provided to the PI for each project. These protocols will enable the PI and any collaborators to recover the cryopreserved sperm in the event of an MTA to another University or institution.

Protocol#______

Transfer sperm to building: ______Room #: ______

PI signature: ______

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