ࡱ> NPM mbjbj *>'8 86,b%.$$$$$$$J&($   $$+"+"+" ^$+" $+"+"J+"@ji+"$$0%+")i)+")+">Q,+"}$j$$Y %    ) :  CAMLS COMPARATIVE MEDICINE SERVICE REQUEST Requests for technical services will not be filled until this form is jointly completed by Comparative Medicine, the PI or designee (e.g., CAMLS coordinator), the CAMLS surgical technologist, and the client/sponsor, and an association is assured in writing between an approved IACUC protocol and fiscal support (e.g., CAMLS billing number). To ensure services are appropriately provided, this written request must be completed no later than 7 days prior to a requested activity. Changes made to a scheduled activity can result in a change order fee depending on costs incurred.  Principal Investigator: IACUC Protocol #: Date:  Course Name:  Course Program Coordinator: Billing #:  The Principal Investigator requests that the following animals be provided the technical services described below: Course Dates/TimesSpecies # / sex / wt.Number of StudentsNumber of StationsLab/Room #Start Time/ Finish TimeOvertime Hours       Course Objectives: Prior Protocol/Template: Technical Staff: Course Instructors (e.g., name(s), contact information): Time of Events ( e.g., animal prep, arrival of instructors/students, start time, finish time): Sequence of Events (e.g., didactic, order of training objectives) Surgical Preparation (e.g., anatomical sites, catheterizations for administrations/monitoring): Supplies Requested/Ordered: Drugs Requested: Equipment Requested: Special Requests/Instructions (photography/video):  Completed By: Date IACUC-Approval Verified:     PAGE  CMDC #202.2 Effective 8/13 -3HWXZ[gxz6 E c f o } # 8  ӽӽӽȪޕk)jh{p55CJOJQJUmHnHu)jh/l5CJOJQJUmHnHu)jh25CJOJQJUmHnHu%jhAu5OJQJUmHnHuhp&5CJOJQJh5CJOJQJhV5CJOJQJhAu5CJOJQJh/l5CJOJQJhAuhVh31&YZ    2 L R S T [ h p $IfgdGf $Ifgd4 $Ifgd; @ ^@ `gd/lgdDe$a$gdgd31    1 2 3 4 8 G K L N R Y Z  * @ H P R ϹĤτyyyyf[P[Ph 25CJOJQJhC:5CJOJQJ%jhAu5OJQJUmHnHuhGf5CJOJQJhV5CJOJQJ)jhGf5CJOJQJUmHnHu)jh45CJOJQJUmHnHuh/l5CJOJQJhDe5CJOJQJhAu5CJOJQJ)jh/l5CJOJQJUmHnHuhS* hAu5CJOJQJaJR S T a b p q } ~ ɾɰۖۈ~t~t~tpeZtZh45CJOJQJhG5CJOJQJhGh4CJOJQJh4aCJOJQJh4h45OJQJ^Jhh4a5CJOJQJh5CJOJQJhDeh4a5CJOJQJh4a5OJQJ^JhGfh4a5OJQJ^Jh4h4ah4uhAu5CJOJQJaJh4uhAu5CJOJQJaJp ~ $IfFf $$Ifa$gd4  $Ifgd4 $Ifgd4 $If]gd4 $$Ifa$ $$Ifa$gdDe $$Ifa$gdw( $If & $Ifgd*zkd$$Ifl4֞:t #]%+:::;::;0+4 lalf4ytLX $Ifvkd$$Ifl4++  &0+4 lalf4p &ytZ%    $IfgdLXfkd$$Ifl4++0+4 lalf4ytLX  + , - $Iffkd+$$Ifl4++0+4 lalf4ytLX  . @ e f g h i rstu&'(*+-.013ƹƹ铈}}vnjnjnjnjh2rejh2reU h_h_h^55CJOJQJhw(5CJOJQJhLXh CJaJh5|h45CJOJQJhC:h4CJOJQJh2h4CJOJQJh4CJOJQJh5CJOJQJhDeh45CJOJQJh45CJOJQJh- 5CJOJQJ&- . g h i $Ifgd2fkd$$Ifl4++0+4 lalf4ytLXi j $Ifgd2fkdM$$Ifl4++0+4 lalf4ytLX  $Ifgd2fkd$$Ifl4++0+4 lalf4ytLXstu $Ifgd2fkdo$$Ifl4++0+4 lalf4ytLXuv $Ifgd2fkd $$Ifl4++0+4 lalf4ytLX $Ifgd2fkd $$Ifl4++0+4 lalf4ytLX $Ifgd2fkd" $$Ifl4++0+4 lalf4ytLX $Ifgd2 $IfgdVfkd $$Ifl4++0+4 lalf4ytLX% $Ifgd^5 $IfgdGffkdD $$Ifl4++0+4 lalf4ytLX%&')*,-/023nigggggggggd^5kd $$Ifl0+ 0+4 lalpytLX 34:;<>FGIXY]^_`abcdefghijklmɾ뺳 h_h_hbh4a5CJOJQJh2reh- CJOJQJhbCJOJQJh4aCJOJQJh4a h4a0Jjh4a0JU3<=>N]^_`abcdefghijklmgd^5gdVgd/l n+&#$+D n+&#$+D&`#$(/ =!@"@#@$@% $$Ifl!vh5:5:5:5;5:5:5;#v:#v;#v:#v;:V l4 F&&&&&&&0+,,5:5;5:5;4alf4pF&&&&&&&yt4Qkd$$Ifl4֞:t #]%+:::;::; F&&&&&&&0+4 lalf4pF&&&&&&&yt4$$Ifl!vh5:5:5:5;5:5:5;#v:#v;#v:#v;:V l40+,,,5:5;5:5;4alf4ytLX$$Ifl!vh5+#v+:V l4  &0+5+4alf4p &ytZ%$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh5+#v+:V l40+5+4alf4ytLX$$Ifl!vh55#v#v:V l 0+554alpytLX^ 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH 8`8 Normal_HmH sH tH D@D  Heading 1$@&5CJOJQJJ@J  Heading 2$$@&a$5CJOJQJDD  Heading 3$@&5CJOJQJDA`D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List 4 @4 Footer  !.)@. 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