INTRODUCTION

This Animal Welfare Assurance (Assurance) sample document is provided to assist institutions with the development of an Assurance in accordance with the Public Health Service (PHS) Policy on Humane Care and Use of Laboratory Animals (PHS Policy). Reviewing the entire document and reading the PHS Policy before beginning to write will facilitate the completion of your institution’s Assurance. Additional guidance, frequently asked questions (FAQs), and suggested references are available on the Office of Laboratory Animal Welfare (OLAW) website.

This sample document should not be used by:

• Foreign institutions.
• Institutions that currently do not have their own animal care and use programs.
• Institutions that are proposing animal activity to be conducted solely at a collaborating institution.

If one of these bullets describes your institution, please contact OLAW by email at olawdoa@mail.nih.gov for guidance.

If you are unsure as to whether your institution is required to submit an Assurance and OLAW has not contacted your institution, please consult with OLAW. Do not submit an unsolicited Assurance. Assurances that have not been requested by OLAW will not be processed.

This sample document supersedes all previous versions. It includes all required elements of an Assurance. Words that are italicized and in brackets [like this] indicate specific information the institution must provide about its animal care and use program. Notes to help in preparation of the document are in brackets [NOTE: like this] and should be deleted from the completed Assurance. Please strive for clear concise text in the document. Adherence to the sample document format will facilitate the institution’s preparation and OLAW’s review of the Assurance.

One or two page attachments are preferred and may be used to provide the following:

• Organizational structure of the animal care and use program.
• Membership of the IACUC Roster.
• Facility and Species Inventory.
• Most recent semi-annual report of program and facilities. This is needed only for programs that are not Association for the Assessment and Accreditation of Laboratory Animal Care, International (AAALAC) accredited.

All other program elements are to be described in the text of the Assurance. Please do not send additional attachments, more comprehensive attachments, or include appendices, binders, or manuals. Due to OLAW’s use of electronic records, we will not accept these separate documents.

Submit completed Assurances to:

Office of Laboratory Animal Welfare/NIH
Division of Assurances
6705 Rockledge Drive
RKL1, Suite 360, MSC 7982
Bethesda, MD  20892-7982 
(For express or hand-delivered mail use ZIP 20817)

All questions concerning this sample are to be directed to the staff of the Division of Assurances at 301-496-7163, or email OLAW at: olawdoa@mail.nih.gov

Individuals not familiar with the PHS Policy, and those preparing an Assurance for the first time, are encouraged to visit the PHS Policy Tutorial.

VIEW THE ANIMAL WELFARE ASSURANCE

• Applicability
• Institutional Commitment
• Institutional Program for Animal Care and Use
• Institutional Program Evaluation and Accreditation
• Record Keeping Requirements
• Reporting Requirements
• Institutional Endorsement and PHS Approval
• Appendices:
  Membership of the Institutional Animal Care and Use Committee
  Facility and Species Inventory

DOWNLOAD THE ANIMAL WELFARE ASSURANCE

If you wish to download the sample assurance for use as a template, click one of the versions below.

MS Word - 130 KB
Rich Text Format - 213 KB

Sample Documents || Annual Report to OLAW
Animal Welfare Assurance || Semiannual Program Review
Semiannual Report || Animal Study Proposal || Tutorial

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