Transgenic Facility Use Billed: __________________ Transgenic Facility Rederivation Form Albert Einstein College of Medicine, Price B110 Principle Investigator______________________________ Reference No. __________________ Contact Person______________________________ Dept.____________________________ Rm/Bldg Address_________________ Date Submitted______________ Grant#_____________________ Phone______________________ Email_____________________________ Mouse strain________________ Mouse line name__________________ Animal Source (Rm#)________________ Your mice are infected by (list all)_________________________________________________________________ Mice have any reproductive problems? Yes □ No □ Animal protocol number______________________ Before procedure reserve spot in quarantine room from Animal Institute Yes □ oviduct dissection training Yes □ No □ prepare 5-10 female/male mice (optimal 3 weeks old female) No □ Step 1 Performed by applicant Day 1 PMS ~2-4pm 5 IU/mouse, IP Hormones will be provided by facility. Day 3 HCG ~12-2pm 5 IU/mouse, IP set up mating at 5pm Day 4 check plugs in morning dissect mice, collect oviducts transfer to Price B110, (person must wipe dish with 10% bleach before carrying to facility). *Person who dissects mice is not allowed to come to the facility; another lab member who had no contact with animals must bring the dish. Notify facility personnel and bring dish before 12 noon. Step 2 Performed by facility embryo cleaning transfer to pseudopregnant mouse oviduct Step 3 Pickup facility will call you to pick up cages *You have to make arrangements for procedure at least a week before. Any questions call Dr. Ken Chen at 718.678.1106 or Marc Vargas at 718.678.1107 Cancer Center Member Non-Cancer Center Member $539 $770 □ □ I have read and/or understand all the procedures detailed above X______________________________________________________________ Date______________________