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UMMC Biobank

Biospecimen Collections

Tissue procurement

biobank---biospecimen-collections.jpgThe UBR prospectively collects remnant tissue from surgical resections. Physicians in anatomic pathology aid with fresh tissue sample procurement. Tissue samples can be provided to investigators fresh (in the appropriate media, ambient temperature), frozen (snap-frozen with or without media), or formalin-fixed.

Blood products

Blood samples are procured by operating room and general phlebotomy staff, and brought to the biobank for processing, aliquoting and storage. Samples collected include whole blood, serum, plasma and buffy coat.

UMMC Biobank Specimen Request



* = Required Fields

Principal Investigator Information

First Name* 
Last Name* 
Institution*
Department* 
Address 1* 
Address 2* 
City/State/Zip Code*  
Phone Number*() - x   
Fax Number*() -   
Email Address* 

Project Information

Project Title* 
IRB Review*
IRB Number
IRB Expiration Date 
Institutional Biosafety Committee Registration
Approval Date 
Location/Room #
Funding Source* 
Grant #* 
Grant Start Date*  
Grant End Date*  
Account # to be charged
Activity #
Brief description of project
Protocol
*.txt,*.doc,*.docx,*.xls,*.xlsx,*.pdf
Collaborators

Biospecimen Request

Anatomic Site* 
Subtype (if known)
Diagnosis*

 
If Other, please explain
Processing*

 
Total number of specimens requested:* 
If requesting FLUID biospecimens (max. 2ml/case): LIMITED QUANTITIES - APPROVAL FROM SUBCOMMITTEE
Serum Volume (in ml)
Plasma Volume (in ml)
Total number of specimens requested:* 
Gender
Race
Additional chart review required
Review information requested
Principal Investigator Signature
Date