Imaging and Histopathology Work Order Form

Fields with asterisks (*) are required.

General Information

First name *

Last name *

Email *

Principal Investigator

Primary Contact (if different)

Department

Projected Date of Service

Type of Service Requested

Detail of Selected Services

Write a brief description of the services you are requesting. For equipment training: Refer to section (D) to determine the appropriate place (1a or 2a) to request training on a specific instrument.

For Histology services; Include the type of tissue preparation (plastic, paraffin, frozen), type of imaging requested (brightfield, epifluoresence, confocal microscopy), number of samples, number of experiment repetitions, etc.

For Imaging services: Include the number of publication quality plates, presentation posters, etc.

HISTOPATHOLOGY SERVICES

1a - Equipment Training

1b - Tissue Processing

1c - Sample Observation/Imaging

1d - Protocol Design

1e - Other Histology Services

IMAGING SERVICES

2a - Equipment Training

2b - Plates for Publication

2c - Poster Printing

2d - Graphics

2e - Other Imaging

List of Equipment Available for Training

Complete 1a in section (C) if you are requesting training on one of the following instruments.

Lieca TCS SP8 Laser Scanning Confocal Microscope
Zeiss AxioImager/Apotome
Leica MD4000b Brightfield Microscope with Full color digital camera system
Topcon Sl7E Slit lamp
Viewlight 8U portable Slit lamp
Phoenix Micron IV Digital Retinal Imager with OCT Attachment
EMS Paraffin Embedding Center
HM 525 Cryostat (two available)
Reichert Ultracut S Ultramicrotome