Animal Ethics Annual Review Form

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Committee for Ethics in Animal Experimentation
Annual Review of Projects using Animals
An annual review of approved projects (by the Animal Ethics Committee) is required under
the Australian Code of Practice for the Care and Use of Animals for Scientific Purposes
NHMRC, 8th Edition (2013). The Code is available at:
http://www.nhmrc.gov.au/guidelines/publications/ea28.
The AEC can approve an application for a maximum of three years. However, the applicant
must submit an annual report at the end of the first and second years of the project for review
by the AEC. At the end of the third year, the Principal Investigator is required to submit a new
application if he/she wishes to continue the project.
Regardless of the duration of the approval, the continuation of all projects is subject to the
receipt by the AEC of a written annual report.
At the end of the project, an End-of-Project form is required to be submitted to the AEC.
The information sought on this form will assist the AEC to monitor the progress of each
project to determine (on the basis of the information supplied) if the project may continue, be
suspended, required modification or be discontinued.
Numbers in square brackets refer to the relevant parts of the above Code of Practice.
Please email a copy of the Annual Review to the Research Ethics & Compliance Officer by
the closing date for papers.
Research Ethics & Compliance Officer
Animal Ethics Committee
Secretariat
animal.ethics@canberra.edu.au
(Revised September 2013)
PART 1
SUMMARY OF APPLICATION PROGRESS
1. Project Number:
2. Chief investigator:
Project Title:
Title
Given names
Surname
Email address:
3. Original project aims:
4. Application progress:
a) This is the 1st or 2nd review for this project (X) Note: after the 2nd renewal a new
application is required to be completed.
b) Has the Project finished? (X) If Yes, please complete the End-of-Project form instead
of this form
PART 2
1st
2nd
Yes
No
CHANGES MADE TO THE ORIGINAL (APPROVED) PROJECT
5.
Please describe any changes made during the past year to the original, approved project and the
reasons for the changes:
6.
project (including any changes in
Please identify any staffing changes to the original, approved
investigators or others directly associated with the project)
Investigators/ Co
Proposed changes
Role
investigators identified
in original project
Are proposed staff changes
authorised? (as required under
the ACT Animal Welfare Act
1992) If Yes, please provide
Authorisation number. If No,
please complete authorisation form.
(Revised September 2013)
PART 3
ANIMALS USED
LABORATORY EXPERIMENTS (ONLY)
7.
Number of Animals approved for use in the original approval
Species name
Strain
Number Source of animals
8.
Did the species, numbers or source of animals vary from that which was approved?
If Yes, Please explain why?
Yes (X)
No (X)
Go to Question 10
9.
Number of animals actually used in the project.
Species name
Strain
Number Source of animals
10.
a)
The housing and feeding of animals used:
Was as described in the approved proposal (X)
Please go to Question 12
OR
b)
Varied from the approved proposal (X)
And are described in Question 5 Part 2
OR
FIELD SURVEY WORK (ONLY)
11.
Please list number and species of animals used (including non-target animals)
Species name
Common name
PART 4
Number
ANIMAL HEALTH AND WELFARE
12.
Did the animals experience unexpected stress or other adverse reaction beyond those expected and
described in the original project application or notified modifications of the original project
proposal, as described in Part 2 above?
Yes (X)
Please go to Question 12 (a)
No (X)
Please go to Question 13
a)
Please describe and explain any unexpected stress of or adverse reaction:
b)
How did you deal with this?
(Revised September 2013)
PART 5
PROJECT RENEWAL
13.
Is continuation of the project being sought?
Yes (X)
Go to Question 14
No (X)
Go to Question 16
14.
Approval for continuation of the project is sought for the period:
From:
To:
15.
a) (X)
b) (X)
Continuation of the project will be:
precisely according to the information provided in the original proposal and any
subsequent modifications of which the Committee has been fully informed and which
have been already approved by the Committee
OR
under the altered conditions as described in Part 2, Question 5 & or 6.
16.
Please provide a short report of the progress of the project to date:
17.
Current Applicant and /or Chief Investigator
Name
Institution/ Division
/Discipline
Room
No.
Telephone
No.
CEAE
Authorisation (X)
Yes
No
1
2
18.
Current list of Co investigators or others directly associated with use of animals in the project
CEAE
Name
Institution/ Division Room
Telephone
Authorisation (X)
/Discipline
No.
No.
Yes
No
1
2
3
4
If you answer No, please complete an Authorisation to conduct experiments using animals
form. All individuals must be authorised before they can be involved in the project. (Add
additional rows if more Co investigators or others directly associated with use of animals in
the project are involved).
(Revised September 2013)
PART 6
DECLARATION BY CHIEF INVESTIGATOR
Statement by Chief Investigator
I have read the current Australian Code of Practice for the Care and Use of Animals for Scientific Purposes,
NHMRC 8th Edition (2013) and have complied with the requirements of the Code, all relevant Commonwealth,
State and Territory legislation and any specific conditions as identified by the University of Canberra Animal
Ethics Committee.
Name:
Signature:
Date:
(Revised September 2013)
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