Lab Registration Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Instructions for Lab Registration Please complete and submit the information below. Some programs require additional documentation. If you have questions, please contact EHS at 205-348-5905. If additional information is needed, a member of EHS staff will contact you. PI Information/Lab LocationName of Responsible Party (PI)DepartmentOffice LocationBuilding and Room NumberOffice Phone NumberCell Phone Number (in case of emergency)Lab Location(s) Building and Room NumberLab Phone NumberPI Email Address *Date / TimeMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Research InterestsPlease provide a description of your research interests and the projects you are proposing to perform on the UA campus.Declaration of HazardsPlease check all the programs or potential hazards found in your lab or work areas. Several areas will require additional documentation.Chemicals are used OR storedBiological materials are used OR storedRecombinant DNA or synthetic DNAEnvironmental samples (plants, trees, soils, etc.)Experiments can have environmental or ecological effectsAnimals are involved in research OR housed in the areaRadiation is used OR stored (sealed OR unsealed sources)X-ray producing equipment is usedLasers are used OR storedMagnetic fields are in useHazardous equipment is in useShop tools are in usePersonnel could experience temperature extremesOccupational exposure concerns (noise, dust, respiratory issues)Construction or transportation concerns existMaterials could be shipped to another locationHuman subjects will be involved in research activitiesHot work (welding, brazing, etc.) will be performedPersonnelFor all personnel with unrestricted access to your lab area, please list their name and current status (UG, G, Postdoc, Faculty, Staff, etc.). If you prefer to send this information in another format, please contact EHS to discuss.Supporting Documentation Please email the following items to Juliette Commodore-Botoklo at jjcommodore@ua.edu: Any existing research descriptions (presentations, publications, etc.) Standard Operating Procedures (SOPs) Any additional information or supporting documents Submit