Tufts Animal Histology Core Submissions

Tufts Animal Histology Core Submission Form
Please complete this form to request histology services. After you submit the form, you will receive an email record of your request. Print out the request and submit it with your tissues. Contact TuftsCMS-histocore@tufts.edu for any questions. Click here for the current Tufts AHC Fee Schedule and a description of our services.

If you are coming from a different campus or are external to Tufts, please contact the histology lab ahead of time for a drop off. For frozen tissues, contact Nathan directly.
Click the "Submit" button at the bottom left of this form when it is complete to send it to the histology staff.
Lab Information
Date

MonthDayYear
PI Name*
PI/Billing contact email*
Name of person completing this form*
Email of person completing this form*
Lab contact phone*
Additional lab contact email (optional)
Institution*

Tufts UniversityTufts Medical CenterOther
Affiliations

Tufts Cancer CenterBNORC
Project Information
Project Name*
Is this project NIH funded?*

yesno
If NIH funded, provide the grant number*
Billing Account #*
Service Request
Species*

MouseRatOther
Tissues submitted*
Fixative

10% NBF4% PFABouin"sEthanolOther
Do the tissues contain bone?

yesno
Have bony tissues been decalcified yet?

yesno
Which of the following sample types are being submitted?
containers of fixed, untrimmed tissuecassettes of trimmed tissuesparaffin embedded blocksfrozen blocksslidesOther
# of containers*
# of cassettes*
The cassettes have been labeled only in pencil or histology pen. Labels will be lost during processing if a standard lab marker such as Sharpie is used.
# of paraffin blocks*
# of frozen blocks*
# of slides
Provide instructions here. # of slides, stains, etc. For cryosections, please indicate preferred thickness*
Slide boxes and flats

I will provide a slide box or flat for slide pickupPlease provide me with a slide box (small fee applies)
Check here if you would like the slides to be sent directly to the Tufts CMS veterinary pathologist for interpretation

true
All tissues left over from the trimming process will be discarded 30 days after services are rendered. Arrangements to pick up leftover tissues or have them stored can be made within that timeframe

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