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In this AUP template, the user can keep a locally stored version of their AUP as a backup and copy/paste text from this template to their AUP document in RMS. This is not a complete template, but an optional tool for RMS users. IACUC will not accept this Word document as a replacement for the AUP application. Please type below each section/question and fill in the fields, tables or drop down lists. Help hyperlinks are active in this template and link out to the online user guide. Hover your mouse over the hyperlink and hold Control and click to follow the link.

Agency Permit # Type of Permit Status(approved, pending)

Expiration Date

Species USDA Pain Category (B, C, D, or E) # of Animals used in last 3 years

Click here to enter a date.

Click here to enter a date.

Click here to enter a date.

Choose an item.

Species Monitoring Parameters Monitoring Frequency Responsible Person

Click on the image above to view detailed instructions on adding animal numbers to your protocol

Choose an item. Choose an item.

Click on the image above to view detailed instructions on adding procedures to your protocol

Species

(receiving the

drug/agent)

Drug/AgentDose Range

(mg/kg body wt)

Route

(SQ, IP, IV, IM, etc.)

Frequency

(how often?)

Duration

(how long?)

Species

(receiving the

drug/agent)

Drug/AgentDose Range

(mg/kg body wt)

Route

(SQ, IP, IV, IM, etc.)

Frequency

(how often?)

Duration

(how long?)

Species

(receiving the

drug/agent)

Drug/AgentDose Range

(mg/kg body wt)

Route

(SQ, IP, IV, IM, etc.)

Frequency

(how often?)

Duration

(how long?)

Building Room #         

Building Room # Duration               

Building Room #Location will be used for:

Non-surgical Procedures Surgeries Housing > 12 hrs                                             

NamePhone #

Daytime After-hours(mobile/cell preferred)

               

Name UCInetID UCI Email               

Name UCInetID UCI Email          

     

Name UCInetID UCI Email