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UC IACUC Form #P-04 University of Cincinnati Institutional Animal Care & Use Committee Request for Exception to IACUC Policy/Regulations Date: Principal Investigator: Department: Protocol Number: Mail Location: Please check the policy you are requesting an exception to (NOTE ONLY ONE MAY BE SELECTED): Policy #001- Non-Traditional Procurement Policy #002- Identification and Genotyping Policy #003- Animal Transportation Policy #004- Use of Expired Medical Materials in Animals Policy #005- Animal Adoption Policy #007- Euthanasia of Rodents with CO2 Policy #008- Cage Identification Policy #010- Anesthesia Requirement for Retro-orbital Blood Collection of Rodents Policy #012- Policy on Housing Animals in Laboratories Policy #012A- Requirements for Mammalian Satellite Housing Policy #012B- Requirements for Ectothermic Satellite Housing Policy #016A- Rodent Survival Surgery Policy #016B- Non-Rodent USDA Regulated Animal Survival Surgery Policy #016C- Ectotherm Survival Surgery and Frog Oocyte Collection Policy #017- Labeling and Storage Requirements for Secondary Containers Policy #020- Use of Analgesics Policy #021- Specifications for Satellite Animal Procedure Areas Other: The Guide for Care and Use of Laboratory Animals: Provide scientific justification for the requested exception: Principal Investigator or co-Principal Investigator’s Endorsement: The requested policy exception is based on scientific justification necessary to conduct the studies in my approved IACUC protocol. I will ensure all approved personnel listed on my protocol are notified of this policy exception. Signature: ______________________________________________________ Date: University of Cincinnati Institutional Animal Care & Use Committee