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					                           New Census #                                                  Old Census #
                                                 Florida Atlantic University
                                                    Veterinary Services
                                             Animal Transfer Form

         A transfer is moving an animal from one protocol to another, one pain level to another, one room to another
             or a combination of the above. It does not include animals weaned or left the University permanently.

Date Form Filled Out                                                               Date of Transfer
The PI is responsible for the                     From (Current)                                        To
accuracy of all information
Principal Investigator
Protocol Number
Account Number

Day Phone Number
Species
Strain
Sex                                                           M              F
Age/DOB
Pain Level
Number of animals to be
transferred
                                    (-)                                            (+)
                                                                                   To be filled
Animal ID Number                                                                   in by OACM

Facility Requested                  Behavioral RSF T5                   BioMed     Behavioral RSF T5            BioMed
                                                 Circle one                                        Circle one

Room Number          Old            New                       Number of Animals per Cage
Was any procedure                   Yes          No           Notes/ Other
performed on the animal                                       Comments
before transfer                     Circle one




                                                      To be Filled out by VS
 Protocol Check                                        Yes         No    Location Room/Facility Check
 Census Check                                          Yes         No    Cage Cards
                                                                         Health Form
 Entry Made In Animal Orders For                       Yes         No    Data Entry Completion Date
 Protocol Animals Are Leaving
 If “No” circled for no procedure performed above, enter new ID number for the animals
 on the old protocol that had animals removed.
 Notes/Comments




FAU Form 08 Transfer Form 3 March 2003

				
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