Overview Mice2

Request for Service (External Users)

Principal Investigator
   
Laboratory Contact Person
Veterinarian
Contact Person for Shipping/Handling
 
Material For Testing
Mouse identifier (strain name used in the laboratory)
Background genetic strain of mice
Backcross history (generations)
Affected locus (all information will be kept confidential)

Nature of genetic manipulation (check all that apply)
Tissue distribution of mutation

If Tissue-specific, check all that apply:
Immune status of mice:
Immune status of mice:
Does exporting institution conduct periodic diagnostic tests on its rodents?
Does exporting institution conduct periodic diagnostic tests on its rodents?

Number and location of mice/cages


Gender
Age
Proposed date of transport
Proposed studies

Please download the attached IACUC Application to Use UMPC and Minor Amendment Form and submit the completed forms to the IACUC office ( angela.muise@umassmed.edu ).