Version: 7.2016 Protocol Associate Addition

Please select procedures below and complete the table as appropriate for each Protocol Associate.  All training needs to be documented and is subject to IACUC inspection.  For information on what CITI training is required: http://researchadmin.iu.edu/IACUC/IUPUI/iacuc_education.html.  LARC Core Training is also needed in order to gain access to LARC: http://medicine.iu.edu/larc/services-and- information/larc-core-training-classes/.  If you have additional personnel, please copy and paste additional rows as needed.  For assistance contact the IACUC office.

Example Name of Protocol Associate (PA) (first, middle Initial, last): John A. Smith Protocol # 12345 PA IU E-mail: [email protected] Emergency Contact: This person is responsible for performing the monitoring x Yes No and managing the complications. Campus Phone: 317-278-9999 Emergency Phone: 317-444-8989 Years of Training Received and by Whom or Procedures this PA will perform: Species Experience To be Provided and by Whom x Breeding, Weaning, and Mice 13 years Trained by PhD advisor Dr. Tink Bell at Texas Genotyping A&M Trained by post-doc mentor Dr. James Hook at IUSM x Anesthesia Mice 10 years Trained by lab animal technicians at Texas A&M and IUSM LARC technicians If performing Gas Anesthesia, has the PA completed the IU required waste anesthetic x Yes No training? For more information, click on the following link: https://protect.iu.edu/environmental-health/occupational-health/anesthetic-gas.html Sedation x Analgesia Mice 10 years Trained by lab animal technicians at Texas A&M and IUSM LARC technicians Non-Survival Surgery Surgery: Injections Rat 13 years Trained by lab animal technicians at Texas A&M x Single Survival Surgery Surgery: Jugular catheters Mice 13 years Trained by lab animal trainer at Texas A&M. Multiple Survival Surgery: Surgery: Agent Administration Irradiation Imaging x Blood Sampling Rabbits 0 years Will be trained by Dr. Dave Jones at IUSM and LARC personnel Behavioral Testing Immunization Hybridoma Physical Restraint Laser Use Animal Identification x Euthanasia x CO2 with flow meter Rats 13 years Trained by lab animal technicians at Texas A&M Other Method: Other Non-surgical procedures Other: Other: Version: 7.2016

Name of Protocol Associate (PA) (first, middle Initial, last): PA IU E-mail: Emergency Contact: This person is responsible for performing the monitoring and Yes No managing the complications. Campus Phone: Emergency Phone: Years of Training Received and by Whom or Procedures this PA will perform: Species Experience To be Provided and by Whom Breeding, Weaning, and Genotyping Anesthesia If performing Gas Anesthesia, has the PA completed the IU required waste anesthetic Yes No training? For more information, click on the following link: https://protect.iu.edu/environmental-health/occupational-health/anesthetic-gas.html Sedation Analgesia Non-survival Surgery Surgery: Surgery: Single Survival Surgery Surgery: Surgery: Multiple Survival Surgery: Surgery: Surgery: Agent Administration Irradiation Imaging Blood Sampling Behavioral Testing Immunization Hybridoma Physical Restraint Laser Use Animal Identification Euthanasia

CO2 with flow meter Other Method: Other Non-surgical procedures Other: Other:

If there are additional protocols, please copy and paste additional boxes as needed. For assistance contact the IACUC office

IACUC Office Use Only

CITI Granite Protocol PI Notified of PA addition Amendment Pending Working with the IACUC Course Minimizing Pain and Distress Laboratory Animal Allergens OHS forms

received reviewed added