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PMCC Biobank
Home
About Us
Our Program
Value & Mission
Bioethics & Privacy
Biobank Team
Executive Committee
General Governance
Our Facility
Our Services
Request Services Form
Accessing Biospecimens and Data
Guidance Flowchart
Biospecimen Inventory
Collection Time Points
Publications
Submit Publications
Search Publications
View Publications
Contact Us
Request Services Form
Step
1
of
4
- Contact
0%
Name
*
First
Last
Job Title
*
i.e., UHN Principal Investigator
Email
*
Phone Number
Study Title
*
CAPCR-ID
Hypothesis & Aims
*
External REB Approval Received (where applicable)
*
Yes
No
Not Applicable
If you have an existing REB approval that does not declare usage of specimens from PMCC CV Biobank, please notify your REB that you will (also) be using specimens from PMCC CV Biobank (specimen types and number). Please provide a copy of this email notification to PMCC CV Biobank.
Biobanking Services
Biospecimen Shipping
Prospective Study Onboarding
Retrospective Biospecimen Requests
Retrospective Biospecimen Processing
Storage
Data Requests
Biospecimen Type(s)
Buffy Coat
Plasma
Serum
Fresh Snap Frozen Tissue
Number of Requested Samples
*
Required volume (mL) of samples
*
Required weight (mg) of Fresh Snap Frozen Tissue
*
Additional Comments
Biospecimen Processing
RNA Extraction
DNA Extraction
Number of Requested Samples
Additional Comments
Type of Data Requested
Biospecimen Inquiries
Demographic Inquiries
Additional Information & Specifications
Additional Services
Consenting
Consulting Services
Database Development
ICF Application Consultation
QA / QC
REB Application Consultation
Training
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Est. Budget
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FCC
(if applicable)
Consent
*
I Agree
I understand and agree to adhere to the contents of "Guideline on Specimen Request, Review, Approval, Release and Use" and I understand that a breach of any of the above statements may impact future ability to obtain samples and data from the PMCC CV Biobank.
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