EmailMe Form - Human Induced Pluripotent Stem Cell Order Form

Your name: *

Email *

PI (lab) Name: *

Deapartment: *

Phone *

### - ### - ####

Do you have BSL-2 authorization on your BUA (biological use authorization)? *

Yes

No

If you do not have BSL-2 authorization please contact your Biosafety liason to add it before placing an order.

Do you have SCRO (stem cell research oversight committee) approval? *

Yes

No

If you do not have SCRO approval, at UC Berkeley please contact Lily Merels lmirels@berkeley.edu to add it before placing an order. If you are not at UC Berkeley please contact your own SCRO representative.

ORDER:

Quantity *

How many frozen vials you need

Cell Line: *

Please select a cell line from this list.

Quantity

How many matrigel coated plates do you need?

Date for cell pickup *

MM / DD / YY

Please bring DRY ICE with you and come before 3pm!!!
We will only email you if we need to reschedule your pickup date.
For labs outside of Berkeley please include your fedex account number, address and phone for shipping along with your chart string for billing

Special Instructions:

Please request any supplies (ROCK inhibitor, mTESR1, StemFlex, accutase, etc) here with quantity needed.