UMMC Biobank

Main Content

Biospecimen Collections

Tissue procurement

The 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

Principal Investigator Information

First Name *

Last Name *

Institution *

Department *

Address 1 *

Address 2 *

City/State/Zip Code *

Phone Number *

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

Collaborators

Biospecimen Request

Anatomic Site *

Subtype (if known)

Diagnosis *

Tumor

Normal

Other

If Other, please explain

Processing *

Frozen

Fresh

Paraffin-embedded

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