University of Alabama

General Registration for Biological Safety Program

Investigator  ________________________________________________________________

Building(s)  ________________________________         Room(s)  ____________________ 

Dept  ____________________________________           Date  _______________________

This form MUST be completed on all submitted project registrations, regardless of the type of research.  All forms must be completed and submitted to EHS to initiate the review process.  All individuals must complete the Biological Safety Training course through EHS prior to initiating work at any level. 

Please check the boxes for the items that are applicable to the research project you are registering: 

_____     Recombinant DNA (NIH Guidelines for Research Involving Recombinant DNA Molecules must be adhered to with regard to all uses of recombinant DNA.  All recombinant DNA work must be registered, reviewed, and approved by EHS and the Institutional Biological Safety Committee, even if it is exempt from the NIH Guidelines.)  Must complete the Application for Recombinant DNA and submit it to EHS (mhuey@ua.edu, Box 870178) with this registration.

_____     Class 1 Biological Agents - Please give the name of the agent(s) below.  This would include any live animals, plants or fungi in the lab area.  Complete the Registration for Biological Agents - Class 1 and submit it to EHS (mhuey@ua.edu, Box 870178) with this registration.                                 

_____    Class 2 Biological Agents - Please give the name of the agent(s) below.  Complete the Registration for Biohazardous Agents - Class 2 and submit it to EHS (mhuey@ua.edu, Box 870178) with this registration.

_____     Class 3 Biological Agents -Please give the name of the agent(s) below.  Complete the Application for Approval and Registration of Biohazardous Agents - Class 3 and submit it to EHS (mhuey@ua.edu, Box 870178) with this registration.

_____    Work involving Whole Animals and Any of the Above Categories - Complete the Research Involving Whole Animals and submit it to EHS (mhuey@ua.edu, Box 870178) along with this registration and the Animal Management Plan, if not already on file.

_____    Work involving Transgenic Plants and Any of the Above Categories - Complete the Research Involving Transgenic Plants and submit it to EHS (mhuey@ua.edu, Box 870178) along with this registration and the appropriate forms above.         

_____     Work involving CDC Regulated Select Agents - Complete the Research Involving Select Agents and submit it to EHS (mhuey@ua.edu, Box 870178) along with this registration and the appropriate forms above.

I attest the the information in the registration in accurate and complete. I am familiar with and agree to abide by the current, applicable guidelines and regulations governing my research, including, but not limited to, NIH Guidelines for Research Involving Recombinant DNA Molecules and the Biosafety in Microbiological and Biomedical Laboratories.  As the Principal Investigator, I agree to accept responsibility for training all laboratory and animal care personnel in the hazards and procedures involved in this research. I understand that all personnel will be familiar with and understand the potential biohazards and relevant biosafety practices, techniques and emergency procedures.  I further agree to notify the University of Alabama Biological Safety Officer and the Institutional Biological Safety Committee of any changes in my research in a timely manner.

Signature: ___________________________________________________________________________

Printed Name: ______________________________________________    Date:____________________