Please consult Canadian Council for Animal Care Guidelines at www.ccac.ca when completing this form. Use this form for up to six lab-exercises within a course provided: a) all are either A or B category of invasiveness; b) proposal fits onto four printed pages. All C-category or higher exercises must be submitted individually using this form. The ACUC encourages the reduction or replacement of live animals where reasonable alternatives exist. Procedures likely to result in pain or distress cannot be justified solely for teaching purposes. Tours through animal units do not require ACUC approval but may require a site-audit (AANNSA).
Complete the form using 10 pt Times New Roman font; note maximum number of characters with spaces (cws) per box.
ACUC File # / Course no. and title: / ►
Course coordinator: / ►
Lab title: / ►
Other instructors: / ►
Classification of Animal Use (√ one);
Zoology (02 03 01) / Agricultural Sciences (02 08 01) / Veterinary Medicine (02 10 01)
Box 1. List of laboratory exercises:
Lab / Species / No. of Animals / No. of
Students / Category
of Invasiveness / Date of
Class / Descriptive title of teaching Exercise
Box 2. Potential Hazards to Human Health (£360 cws). Include chemical, physical, zoonotic, or radioactive; list both risks and precautions
►
Box 3. Importation of Animals to DAL-AC: Specify health checks conducted and/or permits required (230 cws):
►
Declaration: I agree to report any deviations from the protocol to the ACUC and agree to comply with the principles and ethical guidelines of the CCAC, and the ACUC.
Signature of course coordinator: / Date
Approved by: / For 1 year from
Chair, ACUC / mm/yr
File: 2015-000 Page 1 of 4
Box 4. Minor Changes: If this proposal is largely a repeat of teaching exercises previously approved, state the file # and specify and justify the minor changes. If there are no changes, state ‘NONE’ and identify the parent ACUC file #. The purpose of this box is to expedite the review process.Minor or no changes to previous exercises? / Yes / ACUC File # / ► / No
Box 5. Proficiency of the Instructor (s) for each exercise state the name of the instructors and their proficiency
Instructor / Level / Lab exercise
Box 6. Preparation Checklist: to ensure any apparent risks to animal well-being are minimized. Examples: Equipment testing; taking animals off feed; pre-lab training of students.
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Box 7. Details of Procedures: (a) include approved SOP (b) instructor: student: animal ratio (c) instructor demonstrated procedure(s) (d) student hands-on training and number of repetitions (e) target skill level.
Lab / SOP # / Instructor: student: animal ratio / Procedure demonstrated by the instructor / Procedure done by student
(number of repeats per student) / Targeted skill level of training
Box 7 (continued)
Lab / SOP # / Instructor: student: animal ratio / Procedure demonstrated by the instructor / Procedure done by student
(number of repeats per student) / Targeted skill level of training
Additional comments: ►
Box 8. Animal safeguards (£1000 cws):
Given the ratio of students to instructors, state:
(a) how will the instructor maintain full awareness of the well-being of all animals
(b) If the exercise is not going as planned, state the signs of compromised animal well-being
(c) if a student is having difficulty executing a task, at what point does the instructor step-in?
Box 9: Teaching exercises requiring more than one day use of animals e.g. feeding trial (£1000 cws):
State:
(a) who will determine student-animal interaction
(b) the frequency and supervision of monitoring for compromised animal health and/or well-being
(c) relevant SOPs
Box 10. Post-Lab (£250 cws):
State:
(a) what will happen to the animals
(b) prevention of over-use of animals in subsequent classes
(c) frequency and supervision of monitoring for compromised animal health and/or well-being.
Box11. Final check: Ensure all information requested is provided in this form. The proposal must not be longer than 4 pages. The Coordinator submits the form as an email attachment to the ACUC Coordinator
**** Post a copy of the approved protocol at the animal lab location ****
File: 2015-000 Page 1 of 4