Mouse Genetics Laboratory
Request for Service
Thank you for using the Mouse Genetics Laboratory Internet Request for Service Form. We are able to accept this document by email, campus mail, US mail or by Fax. We will contact you to confirm receipt of your request. Please return this form to
Sandra Horn
OR
Laura Bendzick
Phone # - 612-626-5825
Phone # 612-626-3743
Fax # - 612-626-3941
Fax # 612-626-2600
e-mail – hornx001@umn.edu
e-mail – green711@umn.edu
Mouse Genetics Laboratory
Mayo Mail Code 806
420 Delaware St. SE
Minneapolis, MN 55455
Service Requested
Transgenic Mouse Production
SPF Rederivation
Chimeric Mouse Production
Cryopreservation
Special Service
Gene Targeting
Project Name
Date
Investigator
Department
Mailing address
EFS Account String
IACUC Protocol #
RAR Customer #
IBC date of approval
Contact name
Phone
MGL use only
Project Start Date: _______________________
Comments:
FAX
Project Completion Date: ______________________