OHSU Center for Spatial Systems Biomedicine

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Specimen Submission Form

This form is for OHSU customers only. Please complete all fields to schedule microscopy services. Contact FEILivingLab@ohsu.edu if you have questions about services.

Legal Name:

E-mail:

Phone:

OHSU Department:

Principal Investigator:

PI's Mail Code:

Billing Alias:

FAID:

Fiscal Contact Name & Email:

Who will prepare these samples?:

Self-prepared

MMC Core (for fee)

Number of Samples:

Sample Prep Date:

Sample Descriptions: :

In what were your samples fixed?:

How long were your samples fixed?:

In what buffer was your sample submitted?:

Sample Processing:

Embedded - sectioned and stained for morphological analysis

Embedded - in hydrophylic resin and sections for immunostaining

Lifted onto carbon-coated grids and stained (usually for bacteria and viruses)

Other - please describe in "Sample Descriptions" above

How would you like your samples processed?

Should we collect EM images in your absence?:

Yes

Specimen area of interest:

Briefly describe what we should look for in your specimens if we should view them in your absence

Which microscope for imaging?:

OHSU — Oregon Health & Science University

OHSU Center for Spatial Systems Biomedicine

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Specimen Submission Form

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