In-Vivo Animal Core (IVAC) Necropsy, Histology, & Pathology Request Sample Drop-off Locations: IVAC Use Only

Monday Friday, 9:00 AM 3:00 PM 3527 Animal Research Facility 1150 W. Medical Center Drive Ann Arbor, MI 48109-0614 ARF Phone: (734) 936-3803 IVAC Manager: (734) 763-1737

Monday Friday, 9:00 AM 4:00 PM North Campus Research Complex 2800 Plymouth Road B36/G157A Ann Arbor, MI 48109-2800 NCRC Phone: (734) 936-3395 Email: ulam-ivaclab@umich.edu

Date In:

Date Out:

Accession #: Short Code: Investigator: Department:

Lab Contact: Phone: Email:

Species: Xenograft: Yes No (check one)

Initial Fixative: Reagent Submitted in:

Tissue Type: Special Instructions: (attach additional information as needed)

If this is a mouse project, is it related to metabolic disease? ! Yes No (check one)

Do you have a Mouse Metabolic Phenotyping Center (MMPC) order number? ! Yes (please include number here) ______________________ No

! Mouse projects related to metabolic disease may qualify for support from the NIH MMPC Grant. Visit mmpc.med.umich.edu to complete an MMPC order request. The MMPC order number can be added to this form or provided while work is in progress. !

(see key below)

Necropsy QTY Histology (Specials) QTY IVAC Antibodies QTY Cross Reactivity Trim & Cassette Alcian Blue AE1/AE3 + 8/18 P mh Decalcification Alcian Blue-PAS Amylase PZ m Fixed Mouse Necropsy Alizarin Red ALDH1 P hx Small Animal Necropsy (Mouse, Rat) Congo Red aSMA P mrh Medium Animal Necropsy (Rabbit, Cat, Guinea Pig) Gram B220-CD45R P m Large Animal Necropsy (Sheep, Pig, Dog) Grocott Methenamine Silver CD3 P mhn NHP Necropsy Luxol Fast Blue CD4 P m Necropsy Technician Time Luxol Fast Blue-PAS CD8a P m

Masson Trichrome CD31 PZ m Histology (General) QTY Oil Red O Cleaved-Caspase-3

3 P mrhxpc

Paraffin Processing and Embedding Periodic Acid Schiff ER P hx Paraffin H&E Slide (prep and stain) Phosphotungstic Acid

Hematoxylin F4/80 PF m

Paraffin Unstained Slides (remain unstained) Picrosirius Red GFAP P mc Paraffin Unstained Slides (for IHC and/or specials) Prussian Blue GFP PF m H&E Stain (previously prepared slide) Toluidine Blue Glucagon PZ m Frozen H&E Slide (prep and stain) Verhoeff-Van Gieson HER2 P hx Frozen Unstained Slides (remain unstained) Warthin-Starry Insulin PZ m Frozen Unstained Slides (for IHC and/or specials) Other: (please describe) KI-67 P mrhxps Histology Technician Time Ly6G P m

Lyve-1 P m Standard Supplies QTY Neurofilament P mrcs 5 ct. Slide Box Non-IVAC Antibodies

and New Titrations QTY PR P hx

25 ct. Slide Box VWF P mrsc 50 ct. Slide Box (Previously Titrated) Cross-Reactivity Abbreviations Key 100 ct. Slide Box Mouse, Xeno Tissue Paraffin P Reagent Vials Rat Tissue Zinc Z Davinci Diluent Other Tissue Frozen F Renoir Diluent (New Titer) Cat c Van Gogh Diluent Mouse, Xeno Tissue Human h Sucrose Rat Tissue Mouse m OCT Other Tissue Non-Human

Primate n

Negative Control Slides Pig p Pathology Slide Interpretation (select one)

Mouse, Xeno Tissue Rat r

Dr. Robert Sigler Dr. Mark Hoenerhoff TBD Rat Tissue Sheep s Dr. Ingrid Bergin Dr. Kate Eaton Other Tissue Xenograft x

View ULAM Rates * IVAC may not always have positive control for IHC. It is up to the requestor to provide positive controls if not available in our lab.

Rev. 09/19/2018

https://mmpc.med.umich.edu/mailto:ulam-ivaclab@umich.eduhttps://animalcare.umich.edu/business-services/rateshttps://animalcare.umich.edu/business-services/vivo-animal-core

Date In: Date Out: Accession Number: Shortcode: Investigator: Department: Lab Contact: Phone: Email: Species: Xenograft: OffInitial Fixative: Reagent Submitted in: Tissue Type: Special Instructions (attach additional information as needed): Mouse Metabolic Project: OffMMPC Order Number: Existing MMPC Order Number: OffQTY Trim & Cassette: QTY Alcian Blue: QTY AE1/AE3: QTY Decalcification: QTY Alcian Blue-PAS: QTY Amylase: QTY Fixed Mouse Necropsy: QTY Alizarin Red: QTY ALDH1: QTY Small Animal Necropsy: QTY Congo Red: QTY aSMA: QTY Medium Animal Necropsy: QTY Gram: QTY B220-CD45R: QTY Large Animal Necropsy: QTY Grocott Methenamine Silver: QTY CD3: QTY NHP Necropsy: QTY Luxol Fast Blue: QTY CD4: QTY Necropsy Technician Time: QTY Luxol Fast Blue-PAS: QTY CD8a: QTY Masson Trichrome: QTY CD31: QTY Oil Red O: QTY Cleaved-Caspase-3: QTY Paraffin Processing & Embedding: QTY Periodic Acid Schiff: QTY ER: QTY Paraffin H&E Slide: QTY Phosphotungstic Acid: QTY F4/80: QTY Paraffin Unstained Slides: QTY Picrosirius Red: QTY GFAP: QTY Paraffin Unstained Slides IHC: QTY Prussian Blue: QTY GFP: QTY H&E Stain: QTY Toluidine Blue: QTY Glucagon: QTY Frozen H&E Slide: QTY Verhoeff-Van Gieson: QTY HER2: QTY Frozen Unstained Slides: QTY Warthin-Starry: QTY Insulin: QTY Frozen Unstained Slides IHC: QTY Histology Technician Time: Other (please describe): QTY KI-67: QTY Other: QTY Ly6G: QTY Lyve-1: QTY Neurofilament: QTY 5ct Slide Box: QTY 25ct Slide Box: QTY PR: QTY VWF: QTY 50ct Slide Box: QTY 100ct Slide Box: QTY Mouse Xeno Tissue Previously Titrated: QTY Reagent Vials: QTY Rat Tissue Previously Titrated: QTY Davinci Diluent: QTY Other Tissue: QTY Renoir Diluent: QTY Van Gogh Diluent: QTY Mouse Xeno Tissue New: QTY Sucrose: QTY Rat Tissue New Titer: QTY OCT: QTY Other Tissue New Titer: QTY Mouse Xeno Tissue Negative Control: Pathologist: OffQTY Rat Tissue Negative Control: QTY Other Tissue Negative Control: Save Before Completing Form: