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Children's Nutrition Research Center

Houston, Texas

Children's Nutrition Research Center - CNRC
USDA/ARS Children's Nutrition Research Center
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Mouse Metabolic Research Unit (MMRU) Use Request Form

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Date of request:   Date required. mm/dd/yy      Requestor's email: Requestor's email is required. name@bcm.edu
All personnel accessing mice while in the MMRU must be listed below.
Personnel: Email: Phone numbers:
P.I. :  Principle Investigator's name is required. Principle Investigator's email is required. name@bcm.edu PI's office phone # is required. 000-000-0000 000-000-0000
Lead Contact:   Lead Contact's name is required. Lead Contact's email is required. name@bcm.edu Lead Contact's office phone # is required. 000-000-0000 000-000-0000
+ personnel:   name@bcm.edu 000-000-0000 000-000-0000
+ personnel:   name@bcm.edu 000-000-0000 000-000-0000
Grant charge source:   10 digit account number10 digit account number10 digit account number10 digit account number
Approved IACUC protocol number:    AN- enter 4 or 5 digit AN- number IACUC protocol numberenter 4 or 5 digit AN- number IACUC protocol numberenter 4 or 5 digit AN- number IACUC protocol numberenter 4 or 5 digit AN- number IACUC protocol number
Objective of Experiment:

You must cut and paste the relevant part of section H1 from your animal protocol into this text box.

Description of Experimental Design and Protocol:

You must cut and paste the relevant part of section H1 from your animal protocol into this text box.
Housing Requirements:
Are your mice already housed in the CNRF?   Yes No Choose 1 please.Choose 1 please.
If not, please see website for mouse transfer procedure.
Diet(s) to be used:

Do you require special housing conditions (e.g. altered light/dark cycle, room temperature)?
Yes No     If yes, describe in detail your special needs. Choose 1 please.Choose 1 please.
Requested dates for CLAMS scheduling for individual cohort
Preferred start date: Date required.mm/dd/yy
Range of acceptable start dates: Date required.mm/dd/yy  through Date required.mm/dd/yy
Requirements For CLAMS
CLAMS Systems
 Total cages
available		 # of mice requested # of days requested
Food intake/Adaptation: 48 Number between 1-48.Number between 1-48. Number between 1-180. Number between 1-180.
Calorimeter with food intake and activity monitoring:  
* With running wheel: Yes No Yes or No?
Resting Metabolic Rate: Yes  No Yes or No?Yes or No? 		16 and 12* 1-28 1-28 1-180 1-180
Body temperature monitoring: 16 1-16 1-16 1-180 1-180

Treadmill:
With metabolic monitoring:       Date(s) of test: mm/dd/yy   Total hours: mm/dd/yy
Without metabolic monitoring:  Date(s) of test: mm/dd/yy Date required. mm/dd/yy   Total hours: Date required. mm/dd/yy

Body Composition Request
PIXImus
Date of procedure(s):   mm/dd/yy.      Total number of measurements:   A value is required.
QMR
Date of procedure(s):   mm/dd/yy.      Total number of measurements:   A value is required.Number

If you still see this page with your filled in information after clicking the submit button, review this page for missing or incorrectly formatted information.

Once you have made the corrections, click the submit button again. You should be sent back to the MMRU home page if correct.