affy mirna genechip service request formcgs.hku.hk/portal/files/grc/genomics/genechip/affy... ·...
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Website: cgs.hku.hkContact Persons: Allen Chu / Carlos ChoiContact No: 2831-5467 / 2831-5477Email: [email protected] Fax No.: 2818-5653Sample Order No.: AA- ________________________________
Affy miRNA GeneChip Service Request Form
User InformationP.I. Name:
User Name: User Email:
P.I. Email:
User Contact No.: Fax:
Department:
Billing Account:
Project Name/ID:
Sample Submission Date (yyyy-mm-dd):Signature:
Billing Address:
Service
Type of Service:
miRNA 4.0
Other:
Qty:
Qty:
Type of GeneChip:
Full service (Labeling, hybridization, wash, stain and scan)
Hybridization, wash, stain and scan (For non-standard labeling protocol)
Other:
Sample Information
Type of Sample:
MouseHuman Rat Other:
Total RNA mRNA
Culture cells, line:
Tissue, type:
Sample Storage: RT -20°C -80°C4°C
Biohazard Samples: Yes No
Note:- Please select options as appropriate.- For further information, please refer to our website: “cgs.hku.hk”.- We DO NOT accept any sample with potential biohazard.- For Research Use Only. Not for use in diagnostic procedures.- For personal data protection, please be reminded that the submitted sample IDs shouldNOT carry any personal information such as the HKID or passport numbers, the laboratorynumbers of patient reports, or the patient IDs of hospitals.- Please refer to the Privacy and Personal Data Protection Policies athttp://cgs.hku.hk/portal/index.php/policies for information on personal data protection andhandling by CGS.
RNA quality requirements:1. Concentration > 130ng/ul2. A260/280 = 1.7 - 2.13. Consistent 28s / 18s ratio4. RIN >= 8.0
Sample ID Bioanalyzer Order No. 28S/18S RIN Remarks
1
2
3
4
5
6
7
8
9
10
11
12
Is this a follow-up experiment? Yes No
Sign Date Remarks
Sample received by Order receive
GeneChip received from Affy
Coating wells
Labeling and QC
Hybridization
Data QC (1) and upload
Data review by GS and QC (2)
For Official Use
Wash, Stain and Scan
Sample Tracking
Data quality approval
Data delivery to user
Remarks:
Sign Date Remarks
FS Module FS Module
1 7
2 8
3 9
4 10
5 116 12
Invoice
GeneChip lot:
DB
Order, Sample info
Sample Process
Labeling kit Lot:Hybrid protocol:
Labeling protocol:
QC
Payment (For Official Use)
Item Unit Price Qty Sub total (HK$)
AA $ $
AA $ $
Total: $
Job done by: Date:
QA/QC Supervisor: Date:v20181126