Rhode Island Hospital Central Research Facilities

Rhode Island Hospital Central Research Facilities

<p> RHODE ISLAND HOSPITAL CENTRAL RESEARCH FACILITIES LIFESPAN AFFILIATE ANIMAL TRANSPORT REQUEST FORM REQUEST MUST BE MADE AT A MINIMUM OF THE DAY BEFORE THE TRANFER IS NEEDED. (Please return the completed form Central Research Facilities: FAX (401) 444-4195)</p><p>Is this transfer also a request to change ownership of these animals? Yes  No  If YES, please fill out an Animal Transfer Request form.</p><p>Date: Date of Transport: Transporter Information Time for transport: PI Name: Driver Name: Lab member or CRF member must accompany the transport. Contact: Lab/CRF member Name: </p><p>Phone No: Cell Phone No: </p><p>Protocol No: </p><p>DESTINATION Facility: Room Number: </p><p>ORIGIN The investigator sending animals must identify the cages to be moved. Facility: Room No: No. of Cages: No. of Animals: </p><p>Animal ID: Animal ID: Animal ID: Animal ID: Animal ID: CRF USE ONLY APPROVED  DISAPPROVED </p><p>SIGNATURE: ______DATE: ______</p><p>Delivered by: ______Date: ______Time: ______</p><p>Received by: ______Date: ______Time: ______</p><p>Animal care staff: Transfers between RIH/Brown facilities should be performed in Jax or Taconic Shipping Crates or similar barrier equipment and should be decontaminated on arrival at the receiving facility. (alh 13)</p>

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