Tissue Technology Shared Resource

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

(858) 822-1011 histologycore@ucsd.edu

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 FORM

Service C3 MCC (A)

$26.68 $23.00 $35.00 $50.00

$32.48 $28.00 $52.00 $75.00

$205.00 $177.00 $274.00 $398.00

$9.28 $8.00 $11.00 $15.00

$3.48 $3.00 $4.00 $6.00

$5.80 $5.00 $6.00 $9.00

$3.48 $3.00 $4.00 $6.00

$12.76 $11.00 $18.00 $26.00

$3.48 $3.00 $4.00 $6.00

$3.48 $3.00 $5.00 $7.00

BT030 Assay handling / hour

BT031 Technologist time / hour

BT032 Pathologist consultation / hour

BT033 Special stains / slide

BT034 Paraffin sections / slide

BT035 Paraffin embedding / block

BT036 Frozen section

BT037 Slide boxes / Miscellaneous

BT038 Paraffin sections serial > 25

BT039 H&E

NonMCC (B)

Non UCSD(C)

RECHARGES

Tech Initials

EMAIL FORM

Quantity

PI* Contact* Date:

Affiliation*

Index/PO*

Email* Phone

Drop off at

Requisition # Date Completed

Completed by

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