Closure Form Ver 2/09

MAINEMEDICALCENTER Institutional Animal Care & Use Committee

CLOSURE NOTICE

Submit One Signed Paper Copy and Send One Electronic Copy

Please fill in all boxes below:.

IACUC #: / Current Approval Date: / Expiration Date:
Closing Protocol
Complete Sections I and II
Provide a brief report* of your findings below / Place “X” Below

SECTION: I

MANDATORY INFORMATION: Please fill all boxes in this section.
Title of Project:
Principle Investigator:
Principal Investigator: / Date:
Address:
Department:
Phone #: / Fax #: / E-mail:

MANDATORY:

*Please provide a brief report of your findings below: (cell will expand)

SECTION: II

Investigator Assurance

The undersigned, being the Principal Investigator for the research project described on the preceding pages of this document, hereby gives assurance that he/she will comply fully with Federal Law as set forth in the Animal Welfare Act; further that, if the research protocol described herein is approved by the Maine Medical Center Institutional Animal Care and Use Committee the investigator will:

A.Adhere strictly to the protocol as described herein;

B.Seek the consent of the IACUC for any significant change(s) in the protocol before they are implemented, and notify the IACUC of any change(s) in the location(s) where the animal component of this research is carried out;

C.Ensure that all personnel listed herein are qualified and competent to carry out the procedures described and that they understand and accept the necessity for strict compliance with all laws pertaining to the type of animal experimentation involved in this study;

D.Assure that the activities involving vertebrate animals as described in this application do not unnecessarily duplicate previous experiments; (the IACUC may request evidence that appropriate literature searches have been conducted);

E.Agree to emergency veterinary care by the appointed MaineMedicalCenter veterinarian if there is evidence of pain or illness.

F. Utilizes the alternative to animal use information to prevent unnecessary animal use.

  • Ensure that all animal program SOPs are being followed
  • Ensure that protocols involving hazardous material or infectious agents are managed by trained staffed and appropriate safeguards are in use.
  • Appropriate measures are being taken to ensure minimum pain and distress, and humane treatment of the animals is being given.
  • Inform Animal Care Staff when you will not be available, (vacation, and conference). Therefore appropriate animal care can be given.
  • Check on animals at least once per week.

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Signature of Principal InvestigatorDate

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Signature of Department ChiefDate

This Assurance must be signed at time of submission.