ࡱ> +-*g  bjbjJJ .(ub(ub VV8 *>>>>>rrr$rrrrr>>4NNNr>>NrNNN>3LN0NaFaNaN4rrNrrrrr:rrrrrrrarrrrrrrrrVB : Verification of Tetanus Inoculation (for Non-Students) Instructions: Occupational Health and Safety Guidelines state that all persons working with animals should have updated tetanus inoculations. This form must be completed by all persons associated with an IACUC protocol who are not ҹAV graduate or undergraduate students, (e.g., faculty, staff, post-doctoral fellows, or technicians). It should be completed and submitted to the Office of Research Services (ors@luc.edu) at the time the IACUC application is submitted to the IACUC for initial review or when an amendment is submitted to add new personnel to the project. Please indicate the date of your last tetanus inoculation below (if necessary, please verify with your physician). An inoculation must be valid for the full three-year approval period of the protocol. I________________________________________ certify that I received my last tetanus (print name) inoculation on__________________. ___________________________________________ _________________ Signature of Personnel Date     $=L" % u | hjhU hC5\ h:" 5\h:" h:" 5CJ$\h:" 5CJ(\$789:;<=H I J K L M % gdG$a$ gdG,1h/ =!"#$% s2&6FVfv2(&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv&6FVfv8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH DA D Default Paragraph FontViV  Table Normal :V 44 la (k (No List 4B@4 Body Text5\PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w<     @ @H 0(  0(  B S  ?%( 33333 u| u|:" C,:<nG@@UnknownG.[x Times New Roman5Symbol3. .[x ArialA$BCambria Math"1hKgKgtf!43HP ?:<2!xx Verification of TetanusInformation ServicesRios, Jennifer Oh+'0 0< \ h t Verification of TetanusInformation Services Normal.dotmRios, Jennifer2Microsoft Office Word@@&*@x3@x3 ՜.+,0 hp  ҹAV Verification of Tetanus Title  !#$%&'(),Root Entry F03.1Table aWordDocument.SummaryInformation(DocumentSummaryInformation8"CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q