UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC) **Satellite Housing Request** ***IMPORTANT INSTRUCTIONS*** This is a locked form document. Please use the TAB key to move between fields. If you wish to format any of the text within this document, please unlock the document before completing that given section (instructions below). To unlock the form: Instructions for Word 2003: 1. Click on “View” 2. Scroll down to “Toolbars” 3. Scroll down and check off “Forms” 4. The “Forms” toolbar should appear. Click on the lock icon on the right side of this toolbar. This will now unlock the document to permit formatting of text. 5. To lock the document, simply click on the lock icon. 6. DELETE this instruction page from the document once finalized. Instructions for Word 2007: 1. With the document open, select the “Review” tab at the top. 2. Click on the “Protect Document” tab. 3. From the drop down list click “Restricted Formatting and Editing” 4. Scroll to the bottom of the pane and click “Stop Protection”. This will now unlock the document to permit formatting of text. 5. DELETE this instruction page from the document once finalized. Animals cannot be housed outside the animal facility for extended periods of time exceeding 12-24 hours without prior IACUC approval. If Veterinary Resources cannot accommodate a housing request and deems it necessary to establish satellite housing, they will work with the investigator to develop Standard Operating Procedures (SOP) for husbandry and care of animals. Once the SOP is developed in collaboration with, and approved by, Veterinary Resources; the following form accompanied by the SOP and husbandry log should be submitted to the IACUC for final review and approval. Rodents – cannot be maintained outside the animal facility for periods of time exceeding 24 hours. USDA Covered Species – cannot be maintained outside the animal facility for periods of time exceeding 12 hours. UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC) ** Satellite Housing Request ** Date: Principal Investigator: Campus Mail Address: Email: IACUC Protocol No.: Title of Project: 1. Justify the need for satellite housing (why is it necessary to house / maintain animals in the lab). 2. Description of the proposed location. a. Building and Room Number: b. Gross Square Feet: c. Is air flow direction, temperature, humidity and air change rates in this location proper for animal housing? d. What temperature will the room be maintained at and how? e. What light cycle will the room be maintained on and how (12/12, light timer)? f. What measure will be taken to control for pests? 3. Provide a brief summary of the procedures to be conducted in this location. 4. Specify the maximum number of animals to be maintained in this location at any one time. Will animals be group housed or single housed? If group housed, how many per cage? 5. Indicate the maximum duration of time animals will be housed in this location. 6. Describe the animal husbandry to be performed. a. How will daily health checks, feeding and water provision be recorded and who will perform these tasks? Where will food be stored and how? b. If necessary, how will animal cages be changed? How often will cages be changed? How will waste be disposed of? Satellite Housing Addendum Page 1 OAWA Version Date 12/2010 c. Who will provide husbandry and care for animals over the weekend and on holidays? 7. This satellite housing request has been developed in collaboration with, and approved by the Deputy Director, Veterinary Resources. Please indicate the date and time of consult: A copy of the husbandry SOP developed in consultation with Vet Resources is attached. A copy of the husbandry log developed in consultation with Vet Resources is attached. NOTE: A site visit of the area will be performed prior to final IACUC approval. An inspection of this location will be conducted by the IACUC or other federal agencies at least twice a year per federal requirements. For active and/or continuing protocols, I certify that the use of animals has been and/or will be in accord with USDA regulations, the PHS Policy on Humane Care and Use of Laboratory Animals, The Guide for the Care and Use of Laboratory Animals, and the policies established by the University of Maryland School of Medicine. I further certify that no change in this protocol will be implemented without prior IACUC approval. ________________________________________ Signature of Principal Investigator Satellite Housing Addendum Page 2 OAWA Version Date 12/2010