Institutional Animal Care & Use Committee (IACUC) Review Form
Project & Applicant Information
Protocol Number
Date Submitted
Project Title
Principal Investigator
Department
Contact Email
Animal Use Details
Species
Number of Animals
Purpose of Use
Project Duration
Ethical & Safety Review
Does the protocol include pain or distress?
Yes
No
If yes, explain measures to minimize pain or distress
Alternatives to animal use considered
Personnel Training & Qualifications
IACUC Review Comments
Reviewer Comments
Reviewed By
Date of Review
Decision
Approved
Modifications Required
Disapproved