BIOHAZARD SAFETY WARNING AND PRECAUTIONS FOR ANIMAL ROOMS
Effective Date(s), beginning:
Ending:
Biohazard
Building / Room Number:
Sticker Here
Infectious Agent or other Biohazard:
Animal Biosafety Level:
ABSL-1
ABSL-2
Required Personal Protective Equipment:
Respirator
Shoe Covers
IACUC Protocol Number:
Gloves
Gown
Lab Coat
Surgical Mask
Bonnet / head cover
Eye Protection
IBC Number:
Principal Investigator:
Department:
Alternate Contact:
Phone:
Agent Information:
ABSL-3
Bacterium
Phone:
Virus
Parasite
Infectious for (all that apply):
Human
Animals:
Routes of Shedding from Animals:
Urine
Other:
Saliva
Routes of Exposure (all that apply):
Mucous membrane
Fungus
SE agent (prion)
Biological Toxin
Not infectious
Feces
Ingestion
Respiratory
Non-intact skin
Not known
Biological Vector
Clinical Signs of Disease in Humans:
Husbandry Information
Research staff responsible for feeding and care of the animals.
Disposable Cages must be used: used cages must be autoclaved or incinerated.
Animal carcasses must be incinerated (required for all animals infected with pathogens).
Other Information or Procedures:
Signature of Investigator:_______________________________________ Date: ____________________________
Form revised: March, 2011
Airborne