Animal Tissue Transfer Authorization
1. Transferring Institution/Researcher
Name:
Institution:
Contact Information:
2. Receiving Institution/Researcher
Name:
Institution:
Contact Information:
3. Tissue Details
Animal Species:
Type of Tissue:
Quantity:
Date of Collection:
Other Relevant Information:
4. Purpose of Transfer
5. Compliance and Approvals
Ethical Approval Reference:
Relevant Permits/License Numbers:
6. Signatures
Transferring Party:
Date:
Receiving Party:
Date: