Facility Incident Report | Institutional Animal Care and Use Committee

Anyone affiliated with the University of Tennessee, Knoxville may use this form to report a facility related incident to IACUC and OLAC.

Events that happen within a facility or by facility personnel that have a high risk of affecting animal welfare

"*" indicates required fields

Name (optional)

First Last

Phone (optional)

Email*

Facility*

If animals are involved in the facility incident, please provide the species and animal identification number (if applicable).

If applicable, provide IACUC protocol number.

Describe the incident or event below. Provide as much detail as possible.*

Proposed corrective action to prevent similar incidents in the future.*

This field is for validation purposes and should be left unchanged.

The facility incident will be discussed at the next IACUC meeting. The committee may request additional information or request an amendment be submitted to account for any proposed changes.