SOMAScan Assay Sample Submission Form
University of Colorado Anschutz Medical Campus
Please complete this form before submitting samples at the UC Genomics and Microarray Core. We
cannot accept samples unless accompanied by this form.
Refer to the “Recommended Sample Handling and Processing Guidelines” document for sample
collection guidelines.
Sample requirements

Two aliquots per sample, each should have 75µl for a total of 150µl of Human EDTA plasma
(preferred), Serum, or Citrate Plasma in 0.5ml Matrix 2D Barcoded Screw Top Tubes. Tubes can
be picked up at the core facility or purchased from Fisher Scientific Cat # NC0685529.

Avoid hemolyzed (pink/red) or cloudy samples.

Biological samples higher than Biosafety Level 2 are not accepted (no viral or bacterial cultures).

No Radioactive Samples.
1. Contact Information
PI Name
Post Doc/Student/Tech
Institution
Address
City
PI Email
Email
Phone
State
Zip Code
2. Experiment and Sample Information
2.1
Please indicate if there are any special hazards and precautions such as biosafety
level, toxic/chemical level (e.g. chemotherapy agent), potential infectious agents, etc.
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2.2
Sample names and collection method in the box below (add more rows if
needed).
Sample Name
Sample Collection Method
(EDTA Plasma, Citrate Plasma or
Serum)
Group and/or time point
(for randomization
purpose)
3. Data analysis/bioinformatics options
On our own
By a designated bioinformatician
Bioinformatician
Name:
Email:
By UCD Bioinformatics Core
4. Payment Information
4.1 University of Colorado Faculty
Speed Type
CCTSI or Cancer Center
Member
___Yes ___No
4.2 Not Affiliated with the University of Colorado
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Payment by Check
Payment by wire transfer or credit cards
5.
Sample Drop off or by Shipping
Email or call to schedule a time for sample drop off.
Contact
Contact
Contact
Hours of operation for sample drop off
Location/ Shipping Address
An Doan
An.Doan@ucdenver.edu;
(303) 724- 4646
Oky Cho
Okyong.Cho@ucdenver.edu
(303) 724-3367
Wenhua
Wenhua.ren@ucdenver.edu
Ren
(303) 724-8863
9:00am to 4:00pm
Monday – Friday, excluding university holidays.
Genomics and Microarray Core
University of Colorado Anschutz Medical Campus
12700 E. 19th Ave
Bldg: RC-2, Room 9400
Aurora, CO 80045
6. Required Signatures
Please have both the Principle Investigator (PI) that will be paying for the SOMAScan Services and the
Research/Technician/Student/ Post-Doc preparing the samples sign below acknowledging that all of the
information provided on the form is correct. Signature of this form acknowledges that the PI and
Technician/Student/Post-Doc have agreed to all sample submission, quality, quantity, project
scheduling, and researcher financial responsibility requirements. Signature of this form authorizes the
UC Genomics and Microarray Core to order all consumables necessary for the researcher’s SOMAScan
Assays and confirms that the PI is financially responsible for items ordered for their project and all labor
cost associated with the project.
Principle Investigator
Signature
Date
Technician/Student/PostDoc Signature
Date
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