Tissue Technology Shared Resource

3855 Health Science Dr, La Jolla, CA 92093, 5th. Floor )

(858) 822-1011 requests@ucsdtissuetech.net

PI* Contact* Date:

Affiliation*

Index/PO*

Tissue technology Shared Resource Request - Page 1/2

Email*

Request/I nstructions: Did you make a consultation previous material’s drop off?

Sections /Paraffin blocksNo. of sections for DNAor RNANo. of H&E slidesNo. of unstained slides per block

No. of sections for DNAor RNANo. of H&E slidesNo. of unstained slides per block

Fixative Fixation Time (hs)

Organ Type

Species Material submitted

Phone

Drop off at

Type of material *

Did you consult a histotechnician? No

NoYes

Yes

Requisition #

Currently in

List of samples submitted (use a separate page if needed)

Number of samples submitted

Tissue technology Shared Resource Request - Page 2/2

PRINT FORMEMAIL FORM

PI* Contact* Date:

Affiliation*

Index/PO*

Email* Phone

Drop off at

Requisition # Date Completed

Completed by

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address requests@ucsdtissuetech.net