Whole Mouse Phenotyping Service Request Form

Investigator Information


Your Name:

  

Your email address:

  

Telephone Number:

  

Room Number:

  

Charging Instructions:

  

Project

Task

Award

Expenditure

Organization

Animal Information


Name of altered gene::

  

Type:

  

Transgene          KO

Where is the gene expressed?:

  

Number of animals submitted:

  

Gender:

  

Age:

  

Room number:

  

Strain:

  
     

Required Tests


Gross Necropsy only:

  

Yes          No

Gross Necropsy and Histology:

  

Yes          No

Organ Specific Histology:

  

Yes          No

Blood smears:

  

Yes          No

Cytology:

  

Yes          No

Embryo embedding:

  

Yes          No

     
 

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