This is a pre production server
Please complete the following as fully as possible for each sample deposited with ECACC Genetic Support Services
PLEASE NOTE: ECACC is no longer able to store Depositors samples long term free of charge. Depositors will be charged for storage on a per ampoule per year basis; alternatively, if requested, all ampoules will be returned to the Depositor at their cost.
Please enclose copy of REC (Research Ethics Committee) approval or email to email@example.com.
Please enclose copy of purchase order or email to firstname.lastname@example.org.
I have obtained consent from the patient for this blood sample to be stored at the ECACC Human Genetic Repository. I have explained that this sample may be transformed into a permanent cell line, which may be made available to qualified investigators for research, teaching or diagnostic purposes. I have explained that DNA extracted from this blood sample may be analysed for research, teaching or diagnostic purposes.
Please confirm your country of origin from the list below.