Texas Woman's University (TWU)
Institutional Animal Care and Use Committee
Approved Animal User Request
This process is to be used by staff, faculty, and students to receive approval as an animal user in
the TWU Animal Facility and satellite sites. This approval will allow entry to the facility under the
supervision of an experienced animal user who has been granted independent access. If you wish
to have independent (without supervision) access to the facility, the Request for Card Access form
must be submitted separately.
Part I: To be completed by applicant. Once completed, bring to the Office of Research and
Sponsored Programs (ORSP), ACT 7.
Name of Applicant:
Department:
Email:
Status (Select One):
9-digit TWU #:
☐ Faculty
☐ Staff
Phone:
☐ Undergraduate Student
☐ Graduate Student
The required CITI courses should be indicated below. These are dependent on the procedures the
applicant will be performing in the lab. If the applicant is a student or staff, the faculty member
should make these determinations. The IACUC may change these determinations if needed.
Laboratory Animal Welfare Training Courses
"Working with the IACUC Course (required)
Check the appropriate species specific elective(s):
Mice. Family: Muridae Cricetidae
Frogs, Toads or other Amphibians
Rats. Genus: Rattus
Hamsters. Family: Muridae
Gerbils
Guinea Pigs
Rabbits, Family: Leporidae
If you plan to conduct studies that have the
potential to cause "more than momentary pain
and distress" in Mice or Rats you should
complete the module on "Minimizing Pain and
Distress"
Fish in Research
If applicant is a student or staff member:
Name of faculty / supervisor:
Faculty / Supervisor Signature:
Date
PART II: To be completed by student
1. Complete health care form and return to ORSP in a sealed envelope with your name and
include the faculty advisor's name in parentheses on the outside of the envelope. Once this
form is returned to ORSP, it will be submitted to the Student Health Services for review. This
review must be complete before the final approval can be granted. It is strongly suggested
that this form be completed and returned immediately.
2. Read IACUC Handbook included in the Information Package (blue folder)
3. Complete online IACUC CITI training modules as indicated in Part I
4. Interview with two IACUC members (not the IACUC chair or the advisor). The faculty can
assist you with identifying members. When applicant is ready for the interview, he/she
should email the two IACUC members identified and schedule an appointment for the
interview. Part III will be signed by the applicant and IACUC members during the interview.
PART III: Certification and Interviews with IACUC Members
Training requirements for individuals intending to use animals in research, testing or education
on the TWU campus are threefold. It is expected that the 1) applicant will read, study, and
understand the policies, procedures, and guidelines in this handbook, 2) applicant will
successfully complete an online animal training program, and 3) applicant will be interviewed by
two members of the IACUC. By signing below, the applicant verifies that they have read the
Working Safely with Laboratory Animals information sheet and the Texas Woman’s University
Animal Care and Use Handbook, understand all policies and procedures relating to the care and
use of laboratory animals, have successfully completed online animal training, and agree to
follow and abide by the policies as set forth in the Animal Care and Use Handbook.
Applicant’s Signature
Date
IACUC Member Signature
Date
IACUC Member Signature
Date
PART IV: Attachments (the following items must be attached before the final interview with
IACUC chair – PART V).
1. CITI Responsible Conduct of Research (RCR) Training Completion Report
2. CITI IACUC Training Completion Report(s)
All training must be less than five years old.
After Parts I-IV are complete (including filing the health care form with ORSP), contact the IACUC
chair via email to set up an appointment for the third interview.
PART V: Interview with IACUC Chair
Initials of IACUC Chair
CITI Responsible Conduct of Research Training Complete
__________
CITI IACUC Training Complete
__________
Health Status Checked
__________
Passed Interview
__________
IACUC Chair Signature
Date
Once this form is completed and signed by the IACUC Chair, it must be delivered to the Office of
Research and Sponsored Programs in ACT 7. An official email will then be sent to the student and
faculty member to verify that the request has been approved. A signed copy will be maintained
on file in the ORSP.
If you wish to have independent (without supervision) access to the facility, the Request for Card
Access form must be submitted separately. Before applying for independent access to the facility,
note that a student or technician must be an IACUC–approved animal user listed on an approved
protocol for a minimum of two months AND have gained a minimum of ten hours hands-on
experience working within the TWU animal facility under the supervision of the PI or a designee
with the appropriate experience.