Mortality/Euthanasia Report

Observation Date*
MM slash DD slash YYYY
Reported by*
Species*
Cage or Animal ID(s)
# Found Dead/Euthanized*
Location*
Principal Investigator*
Protocol Number*
Clinical signs (any unusual behavior or physical appearance exhibited prior to death or before euthanasia)
Suspected Cause (disease, injury, unknown)
Additional Information (method of euthanasia, actions taken to address problem, disposition of carcass, necropsy submission details, etc.)
Email a Copy of the Completed Form to (separate multiple recipients by a comma ","):
Documentation in PI's Record*
- Check here to confirm mortality or euthanasia is documented in PI's record

OLAC