Animal Care and Use Amendment Form
Oregon State University Institutional Animal Care and Use Committee
Use this form to make a change to an Animal Care and Use Proposal. Return completed form to
IACUC@oregonstate.edu or send to IACUC, Office of Research Integrity, 308 Kerr Administration, Corvallis,
Principal Investigator: Telephone: E-mail
Department/College: Granting Agency:
Which type(s) of changes in protocol are being proposed? Check all that apply.
Change in personnel Change in number of animals
Change in animal species Addition/deletion of procedure
Change in surgical procedure Change in anesthesia or analgesia
Change in animal housing Change in euthanasia method
Change in funding source Change in project title
Change in veterinary care Change in hazardous substance use
Change in category of animal use
Describe all proposed change(s) in detail. If change in personnel, identify personnel no longer involved and new
personnel. New personnel must satisfy educational and occupational health requirements before approval will be
granted. If change(s) proposed add any procedures that have the potential to cause animal pain or distress, then
you must describe the methods and sources by which alternatives to these procedures have been sought. Please
review the original protocol and confirm that all principal investigator assurances apply to proposed change(s).
(Attach additional sheets if necessary.)
Justify the need for these proposed changes.
IACUC Action _____________ Approved ___________________ Date______________
IACUC Amendment Form July 21, 2003