Animal Resources Center Access
NOTE: Access is only granted to individuals whose names are currently listed in the
Personnel section of an approved IACUC protocol in the eProtocol system. If the
individual has been recently added to a protocol, this request form should not be
submitted until the applicant has received an email from IACUC confirming that they
have been formally added. Forms submitted before an individual has been approved by
the IACUC will NOT be approved, and the applicant will need to contact the ARC to reinitiate the approval process once IACUC approval has been given. For special access
requests involving people not participating in animal studies, contact the ARC Director.
Please allow 24 to 48 hours for applications to be processed after being submitted to the
ARC business office.
Section 1:
Complete this section with your general information.
Name, UTEID and Principal Investigator are required.
Section 2:
Specify what building(s) access is required.
Access to the Annex Barrier or ARC Barrier requires additional signatures and an
orientation, which will be issued through the building contact or facility manager.
If keys or keypad access are required, include the room number in the appropriate
section. If keypad access to NHB or DPRI is requested, a facility orientation is required
and PIN will be issued through the building contact. The proximity card will be activated
within 48 hours.
Sign and date the form.
Section 3:
This section is to be completed by the Principal Investigator. Protocol numbers, species,
access hours and PI signature are required.
This form must be completed, signed, dated and returned (in person) to the Animal
Resources Center in order for the request to be processed.
______________________________________________________
NHB – Building Contact - Anthony Garza, 512-232-8091, [email protected]
DPRI – Building Contact - Wendy Walker, 512-495-3034, [email protected]
Barrier – Building Contact – Elena Lightfeather, 512-471-2390, [email protected]
Barrier – Facility Manager – Nachi Shukla, 512-232-2043, [email protected]
06/21/16
Animal Resources Center Access Form
Section 1. General Information
Applicant Name (Last, First): _________________________________________________________________
Check one of these classifications:
o Faculty
o Staff
o Graduate Student o Undergrad Student
o Post-Doc
o UT Affiliate: _______________________
(HRMS assignment required)
UT-Austin EID#: ____________________
Principal Investigator: __________________________________________
Department: ____________________________________________
Lab/Office Phone: ________________________
Email Address: _________________________________________
Cell/Home Phone: ________________________
(please refer to backside for instructions)
Section 2. Access Request
Main entry keycard access
Room number(s) requiring key or keypad access
o ARC Building
_______________________________________
o NHB Vivarium
_______________________________________
o DRPI Vivarium
_______________________________________
o Other: _____________
_______________________________________
o DPRI Surgery – 1.300B
o ARC Barrier - 1.300 suite
________________________
o Annex Barrier – 1.202 suite
________________________
Signature – ARC / DPRI Facility Manager Approval)
(Signature – ARC Facility Manager Approval)
Applicant Signature:_____________________________________ Date: ___________________________
Section 3. Principal Investigator Authorization
Check one of the classifications below:
#1o The individual WILL be working with animals under the protocol numbers listed below, and I understand that it is my
responsibility to assure that they 1) complete all training requirements, and 2) are formally added to the protocol by submitting a
protocol modification to the IACUC. For more information, see: http://www.utexas.edu/research/rsc/animalresearch/
(List the IACUC protocol numbers and species involved here)
Note: Access is contingent on applicant being listed on the IACUC approved protocol.
#2o The individual WILL NOT be working with live vertebrate animals but does require access to the ARC facility
(Explain here)
Provide access dates:
Access should begin _____________________and can be terminated ________________
(starting date)
(ending date, if known)
Select an access category:
oStandard hours (7AM-7PM Sun-Sat)
o Extended hours (describe) _______________________________
I authorize the ARC to grant access requested above to this individual, whose activities will be under my supervision.
P.I. Signature:______________________________________Date:__________________________
Return this completed and signed form to the main office in the ARC building for processing,
Access does require applicant to present a UT proximity ID. Access will be granted within 48 hours.
ARC OFFICE USE ONLY
Keys:
___________________
__________
Bldg Access:
___________________
__________
_______________________
Satellite Access: ___________________
__________
_______________________
Date
Date
Date
Initials
Initials
Initials
Proximity ID #
Proximity ID #
11/26/14