Memorandum of Understanding (MOU) Request for Vivarium Animal Procedure Room Assignment

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The purpose of this MOU is to assign and govern the use of an animal procedure room within
the vivarium to support research. The rationale for providing this space is to ensure that animals
do not leave the vivarium for brief or repeated procedures, thereby minimizing transport-related
stress, improving animal welfare, maintaining environmental and microbiological controls, and
upholding compliance with institutional and regulatory requirements.

Investigator responsibilities include compliance, training, sanitation, recordkeeping, and safety
reporting. SMHS responsibilities include oversight, environmental controls, and coordination.
All activities must comply with applicable laws, regulations, guidelines, and institutional policies.

*Form Updated to April 2026 Guidelines.

Request Type:

This MOU is Between:

Faculty Member: ,School of Medicine and Health Sciences ("SMHS"), and the Office of Animal Research (OAR).

Email:

1. Requested Space (If Known)

Please indicate space that may be appropriate for this project. Final space determination, including room assignment or reassignment, will be made by the OAR Director.

Room Number: , Vivarium Facility:

2. Effective Date:

Date of Access (if Applicable):

3A. Project Scope and Users

IACUC Protocol Number:

Other Users:

Ancillary Protocols/Approvals:

Is this project supported by extramural funds? If so, please indicate:

3B. Proposed Use

Describe your proposed use:

Types of procedures and/or surgeries:

Use of biological, chemical, or radiological hazards:

Special requirements:

Estimated space needed:

Frequency of use (daily/weekly/monthly):

Ability to share space with other users (not simultaneous):

4. Specific Equipment Provided by Investigator:

* must provide value

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5. Physical Requirements for the Procedure Room:

*All non-standard equipment and physical requirements are the responsibility of the investigator.

6. Renewal or Termination

The Attending Veterinarian may halt an activity due to animal welfare concerns in accordance with institutional policy. The IACUC retains sole authority to suspend or terminate animal activities as required.

Access to vivarium space is managed by OAR under the authority of SMHS. SMHS may restrict or revoke access for safety, security, or institutional noncompliance concerns in coordination with OAR/Attending Veterinarian, and the IACUC, to be aligned with institutional oversight and regulatory authority.

This MOU will be reviewed every six (6) months from the effective date, and renewal requires confirmation by SMHS. Continued use of the space is contingent upon ongoing programmatic need, satisfactory compliance history, and written confirmation by SMHS and OAR. This assignment does not convey exclusive rights to the space, which remains under the operational control of SMHS and OAR.

7. Signatures

Once faculty complete their portion of this form, it will be forwarded to the OAR Director/Attending Veterinarian for review of programmatic, operational, and regulatory alignment. Following OAR review and signature, the form will be forwarded to the Research Dean for review and signature. After the Research Dean signature. At this point, the form will be forwarded to the Dean (or designee) for signature and final institutional approval.

Principal Investigator Information:

Name: ,Title:

Date:

PI Signature

Once you sign this form, you are approving this form to be sent to the OAR Director, Research Dean, and SMHS Dean for review.

* must provide value

Add signature

OAR Director / Attending Veterinarian: Have you reviewed this submission and are ready to sign?

* must provide value

Yes No

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OAR Director / Attending Veterinarian Information:

Name: ,Title:

Date:

OAR Director / Attending Veterinarian Signature:

* must provide value

Add signature

Research Dean: Have you reviewed this submission and are ready to sign?

* must provide value

Yes No

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Research Dean Information:

Name: ,Title:

Date:

Research Dean Signature

* must provide value

Add signature

Dean: Have you reviewed this submission and are ready to sign?

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Yes No

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Dean Information:

Name: ,Title:

Date:

SMHS Dean Signature

* must provide value

Add signature

Successfully signed and implemented forms will be kept by each signatory.

Dean: Have you, the Research Dean, and the OAR Director reviewed and signed this form?

Yes No

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