Guidelines for Completing IACUC001D
(Schedule D: Non-Surgical Injections, Anesthesia or Analgesia)
04/25/2008
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All questions must be answered. If some questions are not applicable, please answer NA.
After completing the form, print one copy and sign. Submit the original paper copy with
signature to Deborah Broome, Office of Sponsored Programs and Research (Rm. 149
McLaurin Bldg.) as well as an electronic copy via email (broomed@winthrop.edu). The
electronic copy does not need to show the signature.
Question D1:
•
Indicate the scientific and common name of the species used in the study.
•
Identify all anesthetic/analgesic agents that will be administered before, during
and after the procedure. For each, indicate the expected dose and how the drug
will be administered (oral, intravenous, subcutaneous or intramuscular.).
•
Describe the non-surgical procedure and justify the use of anesthetic/analgesic.
Question D2:
•
Identify all other agents (saline, etc.) that will be injected during the study. For
each, indicate the expected dose, number of injections and how the agent will be
administered (intravenous, subcutaneous or intramuscular.).
•
Justify the use of the injections in the study.