NUS Institutional Animal Care and Use Committee
000/00
Date revised: Dec 12
Attachment C
Tissue sharing form
(for submission by PI who agrees to give away unwanted tissues from animals
of his/her approved protocol)
IACUC encourages the sharing of animal tissues from euthanized animals to minimize animal
use. If you are willing to share the tissues from animals not treated with hazardous substances
or infectious agents, or tissues from control animals, please provide the information requested
below so that it can be made available to researchers on request.
(Please contact Dr Chew Li Li at ext. 63542 or email dprcll@nus.edu.sg for information on
tissue availability)
Protocol No:
1. Animal species:
All species listed in Part A, Table 3.1 of protocol.
All species except the following:
Only the following species:
2. Briefly describe what procedure has been carried out in the animals:
(a)
As described in Part A, 5.1 (b) of protocol. (If you agree to reveal the contents)
(b)
As described below:
3. Has any of the following substances been used on the animals to be shared?
Hazardous chemicals / biochemicals
Yes
No
Radioactive materials
Yes
No
Infectious agents
Yes
No
Human blood, body fluids and cells
Yes
No
Animal cells
Yes
No
Recombinant DNA
Yes
No
4. What are the tissues available to others?
All tissues
All tissues except the following:
Only the following tissues:
5. When will the tissue be available?
Please provide the estimated time animals will be sacrificed, e.g. August, 1 st week of June,
after March, between June and August, etc
Attachment
Institutional Animal Care and Use Committee, NUS
000/00
6. Contact person:
Please provide the name and contact numbers whom researchers should contact for more
information on the tissue availability.
Principal Investigator.
The following person(s):
Name
Signature:______________________
Name of PI:
Attachment
Email
Phone No.
Date: __________________