The form templates are available here so that the requestor may become familiar with the information which will be requested on web request forms. The templates are not editable and cannot be used to submit a request. To request data and/or biospecimens from BioLINCC collections, please visit the Studies page.

Specimen Request Form

* = Required Field

Request Identifier
Create a nickname for your reference.
Requestor Information
Support Information

Approximately how many years has the lead investigator been involved in scientific research?

Click here for more information about this funding opportunity.
If funding is not yet available, please indicate anticipated primary funding source.

If you are requesting materials as part of a funding opportunity application, please provide the date by which your application would be due. Please account for any institutional or internal deadlines. Format: YYYY-MM-DD

Request Details
Resources from multiple studies may be requested via one request form using the above drop down menu.
A brief overview of your research needs.
Describe any additional requirements pertaining to the biospecimens themselves, such as anticoagulant used, additives, preservatives, etc.
Describe the characteristics of the participants to be searched for available specimens. Criteria might include gender, age, disease status, genotype, etc. Be as specific as possible.
Only applicable for studies that have more than one specimen draw point. If any visit is acceptable, please indicate so. Refer to the "Available Biospecimens" tables on each study description page for more information regarding the available visits for each material type. If more than one visit is requested, please indicate if you can accept participants that have specimens available from at least one, but not all of the requested visits.
Approximate count of participants required for your study. This may be the same as the number of specimens if only one draw and material type is needed per participant.
Approximate count of specimens required for your study. This may be more than the number of participants if more than one draw and/or material type is needed per participant.
Please include units.
Please include units.
Describe the assay(s) to be performed and include any test volume requirements.
Describe the assay kit(s)/platform(s) to be used, if applicable.
Also describe your intended use of covariates from study datasets, if applicable.

A "Yes" response defines this as a "Commercial Purpose" request.

Were you an investigator with the original (parent) study(ies) referenced in this request?