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California State University, Long Beach
Office of University Research
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Animal Transfer Form (one species per form)

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Donor Name (P.I.):
Department:
Telephone Extension:
IACUC Approved Project Number:
Date of Request:
Date Transfer Desired:
Species/Breed:
Quantity:
Sex:
Age:
What experimental procedure(s) have these animals experienced?
Signature of Donor:
Recipient Faculty Name (P.I.):
Department:
Telephone Extension:
IACUC Approved Project Number:
Number of Animals Approved for the Project:
Species/Breed:
Total of Animals Previously Purchased and Transferred to the Project:
What experimental procedure(s) will these animals experience?
Signature of Recipient:

For Veterinarian Use Only:

Animal Transfer Request approved? Yes_____ No_____

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