Consultation Form Translational Genomics Core Van Nuys Med Science Building 635 Barnhill Dr Room: B037 Indianapolis, IN 46202 Sunil Badve, MD, Director 317-491-6417 (Office) 317-274-5565 (Laboratory) sbadve@iupui.edu The translational genomics core provides consultation services for research studies of IU Cancer Center members. Services include assistance in: grant application, study design and assay development. To initiate the consultation process, please provide ALL of the following information and e-mail this form to the core director. Then, contact the core to further discuss your project. Origin of tissue: (e.g. human, mouse) Source of tissue: (e.g. brain, heart, breast) Sample format: (e.g. frozen, formalin-fixed paraffin embedded) Total number of samples: Tissue availability: Are DNA or RNA available? If so, are they intact? What are your genes or chromosomes of interest? What kind of assay or data analysis? (e.g. DASL [RNA gene expression profile], GoldenGate [Genotyping/Single Nucleotide Polymorphism {SNP}]) Principal Investigator Information: Principal Investigator: E-mail: Phone: Campus Address: