Application Form to add Authorized Personnel in Ethical ProtocolsPlease note the following instructions:For applications of severity level 4-5 or safety issues in which new officials are added, a meeting with a veterinarian MUST be held following their addition to the protocol, (if not yet performed), in accordance with the instructions from the Ethics Coordinator by e-mail. Therefore, THE AUTHORIZED PERSONNEL IN SUCH PROTOCOLS MUST NOT PARTICIPATE IN A RESEARCH BEFORE UNDERGOING AN INSTRUCTION SESSION Faculty Affiliation * Ein Kerem / Natural Sciences / Social Sciences / Koret School of Veterinary Agriculture (except the Koret School of Veterinary) Details of the PI Name of the Principal Investigator (The HEAD of the Lab, The Professor) * Personal authorization number of the Principal Investigator * E-mail * Details of Contact Person Name of Contact Person * Personal authorization number of Contact Person * E-mail * Phone * Maximum 5 protocols can be asked in this form. 1. Full Number of requested protocol For instance: MD-14-12345-3 Animal Facility and Exact unit/s where the research takes place, including name of building For example: Med School, floor 7 , unit 4 Name\s and valid personal authorization number\s of the requested personnel Please indicate each authorization number next to the person's name To be filled out by the ethics coordinator: Name of Vet / Name of Safety Representative 2. press to add another protocol Full Number of requested protocol For instance: MD-14-12345-3 Animal Facility and Exact unit/s where the research takes place, including name of building For example: Med School, floor 7 , unit 4 Name\s and valid personal authorization number\s of the requested personnel Please indicate each authorization number next to the person's name To be filled out by the ethics coordinator: Name of Vet / Name of Safety Representative 3. press to add another protocol Full Number of requested protocol For instance: MD-14-12345-3 Animal Facility and Exact unit/s where the research takes place, including name of building For example: Med School, floor 7 , unit 4 Name\s and valid personal authorization number\s of the requested personnel Please indicate each authorization number next to the person's name To be filled out by the ethics coordinator: Name of Vet / Name of Safety Representative 4. press to add another protocol Full Number of requested protocol For instance: MD-14-12345-3 Animal Facility and Exact unit/s where the research takes place, including name of building For example: Med School, floor 7 , unit 4 Name\s and valid personal authorization number\s of the requested personnel Please indicate each authorization number next to the person's name To be filled out by the ethics coordinator: Name of Vet / Name of Safety Representative 5. press to add another protocol Full Number of requested protocol For instance: MD-14-12345-3 Animal Facility and Exact unit/s where the research takes place, including name of building For example: Med School, floor 7 , unit 4 Name\s and valid personal authorization number\s of the requested personnel Please indicate each authorization number next to the person's name To be filled out by the ethics coordinator: Name of Vet / Name of Safety Representative Submit
