Key/Card Access Request | Department of Neurobiology and Behavior Cornell Arts & Sciences

PI Information:

PI/Requestor Name *

PI/Requestor Email *

Lab Affiliation *

Please select the lab(s) you will be affiliated with, for which key/card access is being requested.

Key(s) / Card Access Needed For:

Employee/Student Name *

Employee/Student Email *

Key(s) / Card Access Details:

Date needed *

Month

Day

Year

Date of Potential Return

If known.

Month

Day

Year

Key(s) and/or Card Access *

Requirements *

Animal Room Requirements: The following 4 requirements MUST be completed through the IACUC and CARE websites BEFORE this request can be processed. To complete the trainings for Module 1 (online) and for Module 2 (in person), contact Stephanie Martin (sam265@cornell.edu). If any selections are NO, you will be contacted to complete your training before you will be granted access.

	No	Yes
Currently on Protocol? (PI) *	Currently on Protocol? (PI) - No	Currently on Protocol? (PI) - Yes
Health Risk Assessment Completed? *	Health Risk Assessment Completed? - No	Health Risk Assessment Completed? - Yes
Completed Module 1 Training (online)? *	Completed Module 1 Training (online)? - No	Completed Module 1 Training (online)? - Yes
Completed Module 2 Training (in person) *	Completed Module 2 Training (in person) - No	Completed Module 2 Training (in person) - Yes

Building(s) and Room(s) to Access *

Please be specific (example: Mudd, Comstock, Corson, Liddell, Weill).

Additional Information

Cornell Student ID # *