APPLICATION TO USE LIVE VERTEBRATE
AC Application #
ANIMALS IN RESEARCH INVOLVING
Animal Care Program
OBSERVATION OR SHORT-TERM RESTRAINT.
(admin use only)
This application is appropriate for use when the interaction with the regulated species involves only observation or restraint
that is momentary, e.g. manually holding a small animal to allow students to observe identifying characteristics. Projects that
involve housing of animals, transportation of animals, holding of animals for more than a few minutes, or sacrifice, should not
use this application.
Date of
Application:
A. Personnel Information (help):
Primary Contact Name:1
UniqueID (ex: smithja):
Department:
(513) 529 Email address: enter@muohio.edu
Phone:
AALAS Online Training (date):
Date
MU Animal Care training (date):
Date
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Faculty Advisor:
Other Personnel: 3
1. The Primary contact person is responsible for assuring all activities are conducted in accordance with the approved protocol.
2. Qualified Miami faculty advisors are required for all applications for which students are the Primary Contact.
3. Other personnel who will interact with the animals without direct supervision of trained personnel are listed on the “Protocol
Personnel Listing Form” also available on the applications web page. These individuals must have completed the required IACUC
training. An accurate record of personnel interacting with animals is a regulatory requirement.
B. Project Information (help):
Title:
Enter Project/Protocol Title
Funding Source:
C. Animal User Assurances Statements (help)
The proposed study involves the use of live vertebrate animals. I understand that as a researcher, I am
responsible for:
1. Conducting activities involving live vertebrate animals in accordance with all applicable provisions of the
Animal Welfare Act as set forth in U.S. Department of Agriculture, Animal and Plant Health Inspection
Service publication "Part II, 9 CFR Part 3, Animal Welfare; Standards; Final Rule" of Feb. 1991, the U.S.
Public Health Service "Guide for the Care and Use of Laboratory Animals" and this Institution's Animal
Welfare Assurance Statement (A-3161-01 of November 2009). Investigators using wild vertebrates in field
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studies should review the appropriate guidelines for the animal group with which they are working i.e.,
Guidelines for Use of Live Amphibians & Reptiles, Guidelines for Use of Birds in Field Research, Guidelines
for Use of Fishes in Field Research, or Guidelines for Use of Mammals in Field Research.
2. Ensuring that protocols involving live vertebrate animals are submitted via my department head and the
Office for the Advancement of Research and Scholarship to the University Institutional Animal Care and
Use Committee for review and approval prior to initiating animal interaction.
3. Reporting any proposed significant changes in the protocol (e.g., change of numbers of animals, change of
species, change in investigators etc.).
Researcher Signature _______________________________________
(no physical signature required: submission by email attachment from your email address serves as your bond.)
Copies of Miami University's Animal Welfare Assurance statement and the U.S.D.A., NIH and other animal use guidelines are available for
in the Office for the Advancement of Research and Scholarship or in the office of the Director of Laboratory Animal Resources and in some case
online. Questions regarding the completion of the protocol form may be directed to the Office for the Advancement of Research and
Scholarship (tel: 529-3600).
Notes: (for administrative use only ):
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D. Project Information
1. Summarize the purpose of your use of animals in this project (help).
2. Describe the nature and justification for the interaction with animals in this project. (e.g., how will this
interaction increase understanding of the species or system being studied?) (help)
3.
This research will involve brief manual handling of live vertebrate animals (Complete Section E).
This research will involve observation only (no handling of live animals) (Skip to section F).
This research will include both observation and/or handling (e.g. different phases of the research).
(Complete Section E and F)
This research will involve manipulation the environment of the animals that would not occur in the
absence of this research (This is not an observational study, do not use this application, use the
general application form)
Help regarding the nature of interactions
When answering the questions below, it would be wise to read all of the sub-questions in each section before
starting the section. You may answer a question before it is asked only to have to repeat yourself.
E. Handling of Animals
1. List the species (common names and scientific name) and the approximate number of animals that will
be involved in direct handling/restraint. If animals will be encountered in their natural environment and it is
unknown what animals will be encountered, list: i) species that are most likely to be encountered, ii) species
that are most sensitive to perturbation, and iii) species that may be encountered that pose harms to human
health (e.g. venomous, rabies carriers, biting animals etc). (help)
2.
Only the PI or other personnel listed above will manually restrain animals.
Others will manually restrain animals (e.g. find and hold for class observation of morphology)
Holding devices will be used with the animals (help)
Describe below the circumstances under which animals will be obtained to be held, provide a
justification for why animals must be restrained, estimate the length of time animals will be restrained,
and if indicated, describe the restraint devices .
Describe below the environment in which animals will be found and held and risks to animals and
humans that may exist (e.g. terrestrial, aquatic, remotely located, day, night).
Describe below the precautions that will be taken to ensure risk of harm to the animals will be
minimized (help).
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Describe below the probability (citing experience or published data) that the method of capture (e.g.
mist netting) might result in injury to the animal captured (note: methods that include live trapping of
any sort must involve personnel being present to remove the animals, if the activity involves visiting the
trap periodically, the standard complete IACUC form must be used):
Describe below the precautions that will be taken to ensure risk of harm to protocol personnel will be
minimized (help).
3. Describe below the literature review that you conducted to seek:
(provide search strategies and summary of results) (help)
i) alternatives or less ecologically disruptive means of accomplishing course objectives and refined
means of holding animals:
ii) likelihood of encountering species harmful to humans:
iii) potential ecological harm to the planned environment (e.g. possible presence of pathogens that
should not be transported to other sites):
4. Describe the qualifications of the course instructor and other supervisory personnel to handle
animals as proposed (e.g. experience and training) (help):
5. If an animal is injured while being captured or handled, describe the likely severity based on the risks
listed above and action(s) to be taken as a result (help):
F. Observation of Animals (help)
1.
Observed animals will be in a captive state, but the animals are acclimated to their environment (e.g.
Zoo, Aquarium)
Observed animals will be in the species natural habitat (wild) help
2. Observation will be conducted from a distance of approximately:
meters
meters and no closer than:
Describe below the methods and circumstances under which animals will be observed (help).
3. List the species (common names and scientific name) and the approximate number that will be included
in this research as part of observations only. If animals will be encountered in their natural environment and
it is unknown what animals will be encountered, list: i) species that are most likely to be encountered, ii)
species that are most sensitive to perturbation, and iii) species that may be encountered that pose harms to
human health (e.g. venomous, rabies carriers, biting) help:
4. Describe below the literature review conducted (search strategy and summary of results) to seek:
(help):
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i) alternative or less ecologically disruptive means of accomplishing objectives:
ii) likelihood of encountering species harmful to humans:
iii) potential ecological harm to the planned environment (e.g. possible presence of pathogens that
should not be transported to other sites):
5. If observation is occurring in a natural environment, describe the precautions to be taken to minimize
risks identified above both to the animals and environment and to the observers (help):
G. Supplemental Materials: Collection permits etc (help).
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