DLAR EMERGENCY CONTACT INFORMATION

Information to be Used by DLAR Veterinary Staff Only

Project Title:        IACUC Protocol #:

Prinicipal Investigator:      Department:

Work Phone: Emergency (after hours) Phone:

Pager:

Alternate Responsible Individuals:

Name:                                     Department:

Work Phone: Emergency (after hours) Phone:

Pager:

Name:                                     Department:

Work Phone: Emergency (after hours) Phone:

Pager:

If emergency euthanasia is required for an animal and the DLAR veterinary staff is unable to contact the investigator or the designated member(s) of his/her staff, please indicate which tissues/samples need to be collected from the animal, and specifically how they should be stored (e.g. formalin, refrigeration, EDTA tube).

Tissue(s) to be collected:

Fixation or method of storage:

Additional Requests: