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					                                                                                                 OFFICE USE ONLY
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                                                                                                 Permit No. ________________


                                                                  Cadaver and Animal Tissue Notification
                                                                             Animal Ethics Committee




     Scientific use of animals (research and teaching) undertaken by Murdoch University staff and students must
     comply with the requirements of the Australian Code of Practice for the Care and Use of Animals for Scientific
     Purposes 7th Edition 2004 (The Code) and with the Animal Welfare Act WA (2002). Persons using animals for
     scientific purposes must consider the 3 “R’s”: Replacement, Reduction, and Refinement at all times.

     Where animals are obtained as cadavers or where only animal tissues or samples are obtained from third
     parties (e.g. samples from abattoir, tissues from another use, fish frames from fishers) in many cases it is
     sufficient to notify the AEC and a full application may not be needed. If any of the investigators had a part in
     killing the animal or deciding which animal was to be killed, then a full application is usually needed.

     The AEC’s central concern is the provenance of the cadaver, tissues or samples. The benefit to this process is
     that the University will have a developing record of efforts to reduce the use of live animals.

     It is recommended that you contact the Research Ethics Office prior to submitting this form to ensure that the
     exemption applies to the work being considered.

     Once assessed by the Research Ethics office and / or AEC chair, this form may be provided to the committee for
     information. Please print, single sided, do not staple, to facilitate copying and distribution to committee
     members.

     Email completed form to animal.ethics@murdoch.edu.au or send to:

                                                            Research Ethics Office
                                                            Animal Ethics Committee
                                                            Division of Research & Development
       Project Title


                 Is the use of cadavers linked to another project with ethics approval?           Yes             No
                 If yes, please specify the title and project number.



                 Expected commencement date                                    Expected completion date



1.     Details
        1.1      Responsible staff member:
                 Title                Given Name                                 Surname



        1.2      Other staff
                 List co-investigators, including instructors / demonstrators
                 Title          Given name                                Surname




                If there are more than 3 Co-Investigators, please attach a download the “Additional Co-Investigator Form”
                available online and attach to the form.


     Cadaver and Animal Tissue Notification Form 17112010
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2.       Animals
         2.1        What animal species will you be using?



                    Will you be using whole cadavers, organs, tissues or samples? How many cadavers will you be using?
         2.2
                    From how many animals will you be obtaining organs, tissues or samples?



                    Source:
                    (i)   Abattoir                                                         Yes            No
                    (ii)       Other project or researcher                                 Yes            No
                    (iii)      Commercial breeding supplier                                Yes            No
                    (iv)       Farm                                                        Yes            No
                    (v)        Privately owned (attach a copy of the Owner Consent Form)   Yes            No
                    (vi)       Fishers                                                     Yes            No
                    (vii)      Pound or refuge                                             Yes            No
                    (viii)     Other             Specify:                                  Yes            No



3.       Project Details
         3.1      Briefly summarise what will be done with the cadaver, or tissues or samples obtained.



         3.2      Will any of the material be stored beyond this use?                      Yes            No
                  If yes, describe where and how it will be stored.



                  Will any of the material be re-used or be made available for use by      Yes            No
                  others?



4.       Legislative and Regulatory Controls
         4.1 Other Permits, Laws and Regulations
             Is the acquisition, retention or use of the cadavers, tissues or samples Yes                 No
             subject to any permit, law or regulation of the State or Commonwealth,
             e.g. AQIS permit?



                 Are there any known health risks to other animals or staff?               Yes            No
                 If yes, explain the nature of the risk and the precautions to be taken.




Declaration
(i)          The only animals in this project will be cadavers, tissues or samples received from a third party;
(ii)         Ethical issues and impacts of this project will be identified and addressed with the staff and students
             involved;




       Cadaver and Animal Tissue Notification Form 17112010
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Chief Investigator:
Note – this form can be emailed to animal.ethics@murdoch.edu.au to ensure a speedy response. If the form is
     emailed, it is acceptable to type your name into the signature space.
Name:              Given Name                                         Surname
(please print)
                                                                    Date:
Signature:




   Cadaver and Animal Tissue Notification Form 17112010

				
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