SPECIMEN PROCESSING SERVICES
/
Drop-off Date:
/
PRINCIPAL INVESTIGATOR:
Project Contact phone
(Last Name)
(First Name)
PROJECT CONTACT:
Contact e-mail
EXTRACTION SERVICES
WHAT IS TO BE EXTRACTED:
DNA
RNA
Both
(If you do not make a selection your
samples will not be processed.)
How Many?
Please indicate any GRC downstream applications to be run (example: Microarray, SNP analysis, etc.):
SAMPLES SHOULD BE:
Returned to PI
Banked by GRC (charges apply)
(If banking is NOT selected, samples remaining at the GRC will be discarded 30 days after process completion.)
Sample Type
Whole Blood
Tissue
Tube Type:
Type
Cultured Cells
Volume (ml):
Size:
Frozen
Type
Mouthwash
RNA Later
Cell Number
Saliva
Buccal Swab
NUCLEIC ACID ASSESSMENT SERVICES
GRC is not responsible for any material in excess of that required for the services requested.
How many samples are being submitted?
DNA
Quantitation:
Spec
PicoGreen
Whole Genome Amplification:
Qualitation:
From DNA
High Sensitivity Bioanalyzer Assay
From Cells
Other
RNA
Quantitation:
Spec
RiboGreen
Qualitation: (Bioanalyzer)
Pico Chip
Nano Chip
Sample Names and Additional Notes
(Include cell number, quantity, concentration if submitting for bioanalyzer. Attach separate sheet if needed.)
3343 Forbes Avenue, 3rd Floor, Phone: (412) 648-9440, Fax: (412) 648-1891
2/16/2016