qPCR (GENE EXPRESSION) SUBMISSION FORM
Please fill out a separate form for each gene
Name:_________________
Ext.:_______________
Date:_____________
Gene of interest (please include accession number): ______________________________________
Reporter dye? ________ Quencher (BHQ, tamra etc)? ________
Endogenous control: ________________________________
Endogenous control should be determined in advance. Currently available are GAPDH, ß-Actin and
18S.
Species: _________________
Number of samples: _______________
Number of RT- (we recommend RT- for each sample): _______________
Is DNase 1 treatment required?
Please submit sample names in an Excel spreadsheet to Jeffrey Leung and cc Erika Thompson.
Which calibrator do you use for each sample? ______________________________________________
**Sample Minimum Requirements: Preparation start with 200ng/ul Total RNA in 15ul volume (minimum).
RNA in H2O______ TE Buffer ______ EB Buffer______ or Other solution______
If the RNA is not in H2O, please provide buffer as blank.
An initial setup fee of $200 will be billed for EACH gene of interest (inventoried only) ordered or optimized by
the DAF. After initial setup, each sample will be billed at $5.00. There is a minimum billing of 5 samples.
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Account #:_________________
Authorized Signature:_______________________
Lab PI Name:___________________________
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For Core Lab Use
Received:________________
Form modified 10/11/11.
Processed:__________________
Data Sent:__________________