Individual Training Record

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Individual Training Record

Name:

Title:

Work Location:

PI:

Department:

A. I have:

1. Submitted my Occupational Health forms to Occupation Health Program through Environmental Health Services

B. I have attended the following courses or received instruction in:

1. The Ethical Care and Use of Animal Subject through RICRO

2. Introduction to the IACUC and RICRO (on-line exam)

3. Animal Handling and Restraint

4. IBC Training

5. BSL2 training

6. BSL3 training

7. Aseptic Surgical Technique

Starting Date

: ______

1. Animal Bite Instructions (

Must

be reported to supervisor)

2. Incident reporting

3. The emergency action plan for my work area

4. Potential zoonotic diseases which I may be in contact in my work area.

Including:

5. Notification of my responsibility to contact my supervisor for training/information before I perform any task for which I am not trained

6. Personal hygiene in the workplace

7. Location of the emergency shower & eye wash

8. Aseptic technique

9. Animal records with regard to pre-, peri-, and post-op monitoring

10. Animal carcass disposal and handling

11. Identifying pain and discomfort in the animal(s) I am working with

12. Anesthesia monitoring

13. Cold sterilization procedures

14. Safe Handling of anesthetic gases including scavenging procedures

15. Controlled drug records and requirements

16. Chemicals in the lab and location, content and use of the Material Safety Data

Sheets (MSDS’s)

17. Animal handling and husbandry

18. Reporting Animal Care and Use Concerns

19. Blood born pathogen training

20. Autoclave usage

21. Aerosol chamber usage

22. Biosafety cabinet training

23. Chemical safety and disposal training

24. Proper sharps handling

Revised May 2010

Initial Trainer Date

Trainer Date

D. I have read and understand the following Animal Care and Use Protocols on

which I will work with animals:

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

1.

2.

3.

4.

5.

6.

7.

E. I have received the following protocol specific training (i.e. surgical

techniques, euthanasia methods, injection techniques, etc.):

1.

Initial Trainer Date

Initial Trainer Date

Revised May 2010

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