Biosafety Protocol Application

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Lewis & Clark College

Purpose: Each PI/PD should complete this form prior to using recombinant DNA, synthetic nucleic acid molecules, infectious agents or toxins, and/or hazardous biological materials on campus. This form must be updated whenever a change occurs, or at least annually, whichever is more frequent. Work must be reviewed and approved by the Institutional Biosafety Committee prior to initiation.

PI Information

General Information

Project Information

Methods and Materials
Biological Materials to be used

Include information about materials, sources, DNA Inserts, Vectors, Hosts, Genes etc.

select all that apply

Method Risk and Controls

Incident Response

Key Personnel
(typically does not include undergraduate students)

Current Version Information

what changed in this version

Previous Version Tracking

PI Assurance Statement
By signing below I confirm the following:

  • I will abide by the NIH Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules, the CDC Guidelines for Biosafety in Microbiological and Biomedical Laboratories, Lewis & Clark’s Institutional Biosafety Policy, Lewis & Clark’s Hazardous Waste Policy, and all applicable rules and regulations.
  • I will maintain a current record of any transfer of biological materials between investigators at this or other institutions
  • I will ensure that lab personnel involved in the activities outlined in this protocol have read the protocol, been made aware of associated risks, and received training on associated safe practices and procedures.
  • Personnel involved in exposure incidents or those experiencing symptoms of exposure will be advised to seek medical treatment; and lab personnel are made aware of how/where to obtain medical treatment.
  • Emergency contacts are posted in the lab.
  • I will ensure that personnel understand that they must, and how to, report all significant spills or releases, exposure incidents, or symptoms of exposure.
  • I will submit a revised protocol to the IBC if the work described herein changes. 
  • I am not using any of the prohibited organisms and toxins listed on Schedule A.