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Submission of Mice for Rederivation to Specific Pathogen Free (SPF) Status

Please complete the following form, then press the "Submit Form" button.

Contact Information
Name of Principal Investigator:
Contact Person in Laboratory:
Animal Study Proposal Number:
Project ID:
Laboratory:
Institute:
Telephone:
Fax:
Address:
Email:

Information on Mice (embryos or sperm) being submitted
Transgene Name:
Strain designation (dam): Homozygous
Heterozygous
Unknown
Strain Designation (sire): Homozygous
Heterozygous
Unknown
Breeding scheme for rederivation:
male Homo Hetero Wt
female Homo Hetero Wt
Designation of wild-type (wt) if used for rederivation:
  FVB/N
C57BI/6
Other 
Special housing considerations:
Tg+ characteristics (color, size, breedability, etc):
Comments:

Current location of colony
Current location of colony:
Mice currently available: Yes No
Contact person and Title:
Telephone:
Is this a non-NCI facility? Yes No

Receiving Animal Facility
Receiving Animal Facility:
Contact person and Title:
Telephone:

The principal investigator requesting this service must agree to operate in accordance with the NIH Guide for the Care and Use of Laboratory Animals, (ISBN 0-309-05377-3), revised 1996 (a copy is available from the LASP office). I so acknowledge this responsibility.
The principal investigator understands that this rederivation service includes tail clips for genotyping unless otherwise directed.

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