University of Tasmania
Animal Ethics Committee
External Research Project
Notification of UTAS Involvement
and Prior approval of other AEC
Office of Research Services
University of Tasmania
Private Bag 01
Hobart, Tasmania 7001
Tel: (03) 6226 7283
Fax: (03) 6226 7148
E: animal.ethics@utas.edu.au
BEFORE COMPLETING THIS FORM, PLEASE REFER TO THE AUSTRALIAN CODE FOR THE
CARE AND USE OF ANIMALS FOR SCIENTIFIC PURPOSES 8TH EDITION, ITEM 2.6.4
You must attach the following documents for approval by the UTAS Animal Ethics Committee
1. Prior Approval document - Copy of full Animal Ethics application form approved by the
external Animal Ethics Committee
2. Permits - Copy of the approval permit and any other relevant correspondence from the
external Animal Ethics Committee
Name of UTAS Investigator
School or Centre:
Internal Box Number:
Telephone No:
Email:
Role of UTAS Investigator within research:
Project Title:
Ethics Approval number from the external
institution:
Approved under the Australian code for the
care and use of animals for scientific
purposes – state Yes or No
Proposed Commencement Date:
Proposed Completion Date:
Institution:
Name of Animal Ethics Committee:
Email address for External AEC point of
contact:
Names and positions of all other UTAS
staff/students involved with protocol. (Please
provide information on the roles within the
protocol for each person here named)
DECLARATION
I declare that the information supplied above is true and accurate to the best of my knowledge.
If the nature of the project changes or my involvement in the project changes I understand that I am
required to notify the University of Tasmania Animal Ethics Committee.
I am aware of my responsibilities as a University representative and agree to abide by the Code of
Practice accordingly.
I acknowledge that UTAS AEC administrative staff may be required to contact the ‘Responsible AEC’
to ensure the adequacy of all monitoring and reporting provisions relating to this work.
Name: ..................................................................................................................................................
Signature: ............................................................................................................................................
Date: ....................................................................................................................................................
ACKNOWLEDGMENT OF HEAD OF SCHOOL (or higher if the HoS is an
investigator/supervisor)
I, the undersigned, acknowledge that the Faculty has been notified of the involvement of the above person in
the defined external project.
Name: ..................................................................................................................................................
Signature: ............................................................................................................................................
Date: