Request to Ship Animals from ISU to another Institution 

This form must be completed and returned to Laboratory Animal Resources (LAR), 1426 Vet Med.  Following review by the LAR staff, we will contact the Attending Veterinarian at the proposed receiving institution.  Following review of the requirements to send the animals to the receiving institution, a decision will be made regarding possible shipment of the animals.  A date will then be set for shipment.

DO NOT make arrangements to have any animals shipped from ISU.  The LAR staff will refuse to approve shipment/s of animals that have not been appropriately coordinated.  These arrangements must be made by, and coordinated by, the LAR staff to ensure that appropriate support is available and that all requirements have been met.

 ISU Information/Data 

Principal Investigator:  _____________________________________________________

Department:_______________________________________________________

Telephone: ____________________Fax:___________________

Approved Active IACUC Protocol Number:___________________________________     

Name of facility and room number at ISU where animals are housed:________________

_______________________________________________________________________

Species of Animal(s):  _____________________________________

            a.) List individual Cage Card number (s):  _______________________________

               ________________________________________________________________

            b.) List individual Animal ID number(s) (if applicable):  ____________________

               ________________________________________________________________

Anticipated shipping date:  _________________________

How will animals be shipped: _______________________________________________

Contact Person in ISU PI’s laboratory: ________________________________________

            Telephone:____________Fax:_______________Email:_____________________

Does LAR have a copy of animal(s) health records?  Yes______                      No_______

 Extramural Institution Information/Data 

LAR Contact person: ______________________________________________

Telephone: ______________Fax:__________________Email:_____________________

Institution Name: ________________________________________________________

Institution Address: ______________________________________________________

Principal Investigator: _________________________________________________

Department: _____________________________________

Implementation Date: 4/15/2009