NeuroBehavioral Facility Core (NBFC)
User Form Submission

New Users: This form is to be completed after your experimental consultation with Dr. Zarcone.
Current Users: Please complete a new form for any additional projects to be conducted at the NBFC.

All fields are required, unless otherwise stated. Tab between fields. Thank you.

PI:
Department:
Project Title:
Is this project:
UCAR Protocol Number(s) for this project:
NBFC Services To Be Used:
(check all that apply)		 Tattoo Identification
Operant Chambers (with photo-beams)
Operant Chambers (with levers)
Force-Plate Actometers
Locomotor Chambers
RAPC
Animal Information
Species: Mouse Rat
Strain(s): (optional)
Estimated Quantity: (optional)
Brief Description of Treatment
(Experimental Group):
Contact Person/NBFC User Information
Name:
E-Mail:
Phone:
Room:
Box Number:
Billing Information
Account Number:
Please send a copy of billing to: (optional)
Name:
Box:
Please enter any other specifications
or additional comments here:
(optional)
A confirmation e-mail will be sent to the above entered email address, so please verify that this is correct.
Thank you!
-NBFC--University of Rochester Medical Center-

NeuroBehavioral Facility Core (NBFC), does not distribute or sell email addresses.