APPLICATION FOR TISSUE MICROARRAY SLIDES
I. DIRECTIONS: Please download an application form here (Microsoft Word form), or call (434) 924-9879 to have a form faxed to you. The information requested in this form is necessary in order to correctly document your request for tissue microarray (TMA) slides from the Cooperative Human Tissue Network (CHTN).
A. Please fill out the application form on your computer or print out the application in paper form and fill out neatly.
B. There is a fee for each TMA slide plus shipping charges. Descriptions of available TMAs and fees are available here, or by calling (434) 924-9879.
C. Each investigator may request a maximum of 10 slides from any particular TMA design.
D. In order to prioritize your application, please provide responses to parts III. A and III. B of the application form.
II. By obtaining TMA slides from the CHTN, the investigator agrees to and understands the following:
1) The investigator agrees to cite the CHTN in their resulting publications in the following manner: "Tissue microarray slides were obtained from the Cooperative Human Tissue Network of The National Cancer Institute, The National Institutes of Health, Bethesda, MD, USA."
2). The tissue microarrays are provided to the requesting investigator only for research purposes and not for diagnostic purposes. Please note that the tissue samples are anonymized and no further clinical information is available other than the data that accompany the arrays. Recontact of subjects participating in the TMA resources is not possible.
3). The investigator agrees not to distribute these microarray slides to a third party without authorization and written documentation from the CHTN.
III. Please email, fax or mail the completed application form to :
University of Virginia Health System
CHTN, Mid-Atlantic Division
Dept. of Pathology
PO Box 800168
Charlottesville, VA 22908
FAX: (434) 924-9438
Phone: (434) 924-9879
email: crumpel@virginia.edu