This form can be submitted with or without your identifying information (below). We prefer that you identify yourself so that we can contact if we need additional information. Also, if we know your identity, we can provide feedback about the resolution of the issue. Even if you provide you contact information, your confidentiality will be protected to the extent that it is legally possible to do so, even if you provide your contact information.
After you submit this form, the Chair of the Institutional Animal Care and Use Committee (IACUC) or the Director of the IACUC Office will investigate the situation you have reported.
Please provide the following details, if possible:
- Description of the incident
- Whether you witnessed the incident first hand
- Location of the incident (building name, room number, name of Principle Investigator if this occurred in a laboratory, etc.)
- Date of incident
- Name(s) of personnel involved in the incident
- Whether you have reported this incident to anyone else, and if so, what action was taken