Request for Grant Application/IACUC Protocol Congruency Review

I. Grant Application Information
a. Grant RAMSeS IPF Number:*
b. Lead Investigator(s) on Grant:*
c. Grant title:
d. Sponsor:*
II. IACUC Protocol Information
a. IACUC Protocol Number(s):*
b. Lead Investigator(s) on Protocol:*
III. Contact Information
a. Requester Name(s):*
b. Requester Email(s):*
c. Requester Phone Number(s):
d. Requested Review-by Date:
(turnaround time is generally 5 business days)
MM slash DD slash YYYY
IV. Subcontracts/Collaborations

If the grant includes any proposed subcontracts in which animal work will be performed outside of UNC (including experiments, custom-generation of animals/tissues/antibodies specifically for these studies, etc.), please provide the following:
a. PI name:
b. PI email:
c. Institution name and physical location:
d. Species to be used:
e. Brief description of work to be performed by collaborator:
(e.g. Scope of Work, Vertebrate Animals section, etc.)
V. Additional Information

In order to facilitate the review process, please provide any additional information that may be important/helpful to the reviewer. For example:
a. Have any of the major aims or approaches changed since the initial submission?
b. Are there any changes to the species used, surgeries, drugs/agents/cell lines, anesthetics/analgesics, euthanasia methods, or experimental conditions that will not be conducted as they are described in the grant application?
If so, please explain these changes and their justification.
You should receive an email confirmation of your request by a member of the Office of Animal Care & Use within 24 hours. If you do not receive your confirmation, please contact OACU at iacuc@med.unc.edu or 919.966.5569.
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Request for Grant Application/IACUC Protocol Congruency Review

I. Grant Application Information

II. IACUC Protocol Information

III. Contact Information

IV. Subcontracts/Collaborations

V. Additional Information