ANNUAL REPORT
 

Date of This Report                          Return by_____________ 

Protocol #                      Date Approved________________ 

Principal Investigator ____________________________________________________________ 

Title _____________________________________________________________________________________ 
_________________________________________________________________________________________ 
 

Federal Law (Animal Welfare Act), which governs the use and care of all laboratory animals, requires that all projects involving animals be supervised by the Institutional Animal Care and Use Committee. As Parts of this, the USDA requires that the IACUC review each approved animal protocol annually (Subchapter A, Section 2.31.5). Please complete this form and return it promptly to this office (see below).  Thank you for your cooperation.
 

1. Current status of project: 

____Continuing       Completed   ____Suspended        Terminated

2. Brief summary of findings to date: (one sentence) 
 
 

3. Has the protocol changed significantly since it was originally approved by the IACUC? 

____No       Yes

___No      Yes

Any and all significant changes in the conduct of an approved animal protocol must be approved by the IACUC before the changes may be put into effect by the investigators. 
 
 

Name (PRINTED)______________________________________________________________________ 
 

Signature________________________________________________    Date ____________________ 
 

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Return to H.M. Richter, III, M.D., Division of Theoretical Surgery, Room 905 Hektoen

For office use only 

Reviewed by: _____________________________________________   Date_______________________