Specimens Feasibility Request – CFAR Network of Integrated Clinical Systems (CNICS)

Specimen Feasibility Request

Lead Investigator Name *

Institution *

Email Address *

Phone Number *

Other Investigator (1) Name

Institution

Other Investigator (2) Name

Institution

Other Investigator (3) Name

Institution

Brief Background of Project

Project Title

Number and Type of Specimens Desired

Laboratory where specimens will be sent

Laboratory Type *

Laboratory Shipping Address

Receiving Laboratory Contact Person Name

Email Address

Phone Number

If suitable specimens can be identified for your project, you will be asked for your preferred overnight shipping carrier with account number. Investigators are expected to pay for the labor costs of retrieval and packing of the selected specimens (depends upon number of specimens, but typically a small cost) as well as the actual shipment (depends upon the carrier used, weight, and distance).

Upload a copy of the PIs CV *

Maximum file size: 52.22MB

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