Illinois State University

Institutional Animal Care and Use Committee

Protocol Review and Comment Form

General Information

Protocol «IACUCNumber» PI Name: «PIFirstName» «PILastName» Date: Reviewer:

Protocol Title «ProtocolTitle»

ACC = Acceptable N/ACC = Not Acceptable N/APP = Not Applicable

Protocol Description:

/ ACC / N/ACC / N/APP /
A. What is the goal/specific aim of this research? Is the research or development question clearly stated? In layperson’s terms, has the relevance of the study been described in regards to advancing scientific knowledge and/or the benefits of the study to human and/or animal health. Has sufficient information been provided to indicate that the new knowledge from the project justifies the use of animals.
Reviewer Comments on A:
B. A complete and accurate description of what will be done to the animals is provided. All procedures are described, including their frequency and time points over the course of the experiments. Length of time animals will be maintained is provided. Dose and route of administration for any drugs to be used is clear. Methods used in behavior studies (including use of noxious stimuli or other methods of reinforcement or punishment) is clearly described. Surgery is described here only as it relates to the study design. For animals used in agricultural projects, if appropriate, IACUC approved Standard Operating Procedures for the agricultural animal facility for that type of animal are referenced. (e.g., sheep, swine, dairy etc.)
Reviewer Comments on B:
C. Experimental and control groups are listed. The number of animals in each are indicated. The number of animals adds up to the total number of animals requested in section II, page 1 and, if appropriate, those discussed in Appendix
Reviewer Comments on C:
D. Justify the species to be used in the research model
1. The features of the species (e.g. anatomic, physiologic, genetic, etc.) that make selection of this species the most appropriate model for this project are described.
2. The number of animals requested for each species has been justified.
Reviewer Comments on D:
E. Pain and Distress
1. Any problems the animal may experience as a result of this project are described.
2. The steps that will be taken to alleviate any pain, distress or discomfort the animals may
experience is outlined. The dose, route of administration, frequency, and type of analgesic drugs or tranquilizers to be administered is included.
3. The monitoring of pain or distress is included.
4. Any inoculation of animal tissues, or body fluids have been screened for the presence of animal pathogens.
Reviewer Comments on E:
F. Euthanasia/Disposition of Animals
1. The euthanasia or disposition of animals at the end of the study is described.
2. For animals that will be allowed to die as a result of experimental manipulation, a scientific justification is provided.
3. Even though euthanasia may not be planned for a particular project, a contingency plan for all protocols in the event that it becomes necessary is provided. This includes the criteria to be used to determine that euthanasia would be required prior to the end of the study.
4. The method, agent, dosage and route of administration to be used for euthanasia for each species is clearly outlined. Any deviations from the AVMA reference are justified.
Reviewer Comments on F:
G. Procedures on live animals be performed outside of IACUC approved animal facilities are explained and location is provided.
Reviewer Comments on G:

PI Statement of Assurance

ACC / N/ACC / N/APP
A. List of all personnel who will have animal contact is complete.
B. Principal Investigator Assurance and signature is provided.
Reviewer Comments on PI Statement of Assurance:

Appendices

Appendix / ACC / N/ACC / N/APP
A. Administration of Non-Pharmaceutical Grade Compounds
Reviewer Comments on Appendices:

Additional Comments:

_____ Recommend approval

_____ Recommend approval after satisfactory revisions (see comments above)

_____ Recommend withhold approval and request full committee review.

Signature of Reviewer ______Date______

Please return this form to: Research Ethics & Compliance

Campus Box 3330

Normal, IL 61790-3330

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For Administrative Use

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Animal Species and Numbers to be Used, Classified by Stress Levels.

ACC / N/ACC / N/APP
A. Numbers to be used & classification
B. Animal Housing
C. Animal Source Information
Comments

Protocol checklist complete and appropriate appendices attached

_____ Acceptable _____ Not Acceptable