GENERAL REQUEST FOR ACCESS TO A COMPARATIVE MEDICINE &
ANIMAL RESOURCES CENTRE (CMARC) ANIMAL FACILITY
Your facility access request will only be approved if all of the following conditions are met:
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Be listed on an approved animal use protocol (AUP) on Darwin.
Contact the facility supervisor to schedule and complete the specific facility or room orientation. Email
arc.info@mcgill.ca to find out the contact information for the appropriate supervisor if required.
Give this completed form & a copy of the front of your McGill ID card to the supervisor on the day of the
orientation (one form for each facility request).
For NHP room access, please provide your latest TB test results and photocopy of your Medicare card.
If you do not have a McGill ID card, arrangements may be made to obtain a temporary access card.
APPLICANT INFORMATION
Animal Facility Name: _____________________ (McIntyre, Goodman Cancer Centre, Ludmer, Genome, Stewart Bio, Duff, OR SARU)
Applicant’s First Name: __________________________________ Applicant’s Last Name: ________________________
Phone number during office hours: _________________________ McGill ID# or temp card#:_______________________
Protocol #: ____________________________ McGill or MUHC Email: ________________________________________
TYPE OF ACCESS
Access From:____________________ To: ___________________ (Maximum expiry date for McGill ID is 5 yrs & for temp cards 2 yrs)
MM/DD/YY
MM/DD/YY
First time access request for a CMARC facility
Request to renew access
Please check only one of the following:
Regular access hours only (Monday through Friday, 7:30 am to 6:00 pm) to room(s): _________________________
*Special 24 hour Access to room(s): ________________________________________________________________
*Reason for the special access request: ______________________________________________________________
Principal Investigator’s name (print): ______________________________ PI’s signature: _________________________
CERTIFICATION
I understand that I will be held solely responsible for my actions while working in any CMARC animal facility. MY
ACCESS PRIVILEGES MAY BE PERMANENTLY REVOKED IF I KNOWINGLY ALLOW MY ACCESS CARD TO
USED BY SOMEONE OTHER THAN MYSELF OR IF I DO NOT ABIDE BY ALL GUIDELINES & PROCEDURES
WITHIN THE ANIMAL FACILITY PERSCRIBED IN THE ORIENTATION PACKAGE I RECEIVED, THE GUIDELINES
SET FORTH BY THE UACC, FACC OR THE CCAC (i.e.: failing to follow approved protocol procedures,
transferring animals without approved documentation, not wearing mandatory personal protective clothing
requirements, etc.)
Signature of applicant:___________________________________________
Date:__________________________
CMARC OFFICE USE ONLY:
CMARC Management Approval: __________________ Date: _____________________ Entered by: ________________________
Type of Access Granted: _______________________________________________________________________________________
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Implemented January 1, 2014 (N:\ARC Animal Care Services\Access)