Animal Order Request - Contract Work Only
Please complete this form to request animal orders for contract work imaging studies.

Mondays (week 1) - Imaging Center's deadline for orders, to adhere to DLAM deadlines
Fridays (week 2) - animals available for use, if animals were available at time of request

Requestor's Full Name *
Your answer
Company/Institute Name *
Your answer
Principal Investigator (PI) *
Your answer
Project ID *
e.g. COM12 or COM12-025
Your answer
Contact E-mail *
Your answer
Phone # or Ext
Your answer
Order Details
Strain *
Name listed on vendor site (e.g. NOD.Cg-Prkdc_scid Il2rg_tm1Wjl / SzJ)
Your answer
Number of animals (e.g. 10) *
Your answer
Vendor (e.g. Jackson Laboratory) *
Your answer
Catalog Number *
e.g. 005557
Your answer
Age or Weight at Delivery (weight may be by ranges) *
e.g. 7 weeks or 120 grams
Your answer
Sex *
Date Needed (please note timeline above) *
MM
/
DD
/
YYYY
Additional Information for Imaging Staff
Your answer
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