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Biobank Registry: Profile submission form
Biobank / Lab Name
*
Biobank objective / description:
Principal Investigator
*
Dr.
Miss
Mr.
Mrs.
Ms.
Prof.
Title
First name
Last name
Does your biobank collect samples from participants with normal healthy skin?
*
yes
no
Please list the skin conditions represented in your biobank:
*
Please indicate anatomic sites from where the specimens are collected:
What specimen types are stored in your biobank (select all that apply)?
Specimen type - Tissue
Fresh
Frozen
OCT TM embedded
Formalin Fixed Paraffin Embedded (FFPE)
Other
Please specify if other
Specimen type - Cell & Cell lines
Fresh (live viable cells)
Cryopreserved cells
Cell extracts for analyses
Specimen type - Blood & Blood derivatives
Whole blood
Fluid derivatives (plasma, serum)
Cellular derivatives - Peripheral blood mononuclear cells
Specimen type - Other derivatives
RNA
DNA
Free circulating nucleic acid (fcDNA and fcRNA)
Protein isolates
Histology slides
Specimen type - Swabs
Traditional Microbiology
Genomic Analysis
Specimen type - Other
Urine
Saliva
Other
Please specify if other
Location - City
*
Location - Province
*
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Name of the biobank contact (if different than PI)
Dr.
Miss
Mr.
Mrs.
Ms.
Prof.
Title
First name
Last name
Contact Email for biobank enquiries:
*
Enter Email
Confirm Email
Submitted by:
*