Collaborative Research Service Sample Submission

Collaborative Research Service Request Form

Please use this form to request services and to submit samples.

URL

This field is for validation purposes and should be left unchanged.

Contact Person(Required)

First Last

Phone

Email(Required)

PI Name(Required)

First Last

PI Email(Required)

Address

Street Address Address Line 2

Submission Date

Department Name

Fiscal Contact Name

First Last

Fiscal Contact Email

Billing Cost Center (CC00XXXX)(Required)

Billing Worktag (GR, GF, PR, or PG)(Required)

Do you have IRB approval?

IRB APPROVAL

Yes

Not Applicable

UW or External #

Service Requested:

Metagenomics

Epigenomics

Illumina Sequencing

Ultima Sequencing

Long-Read Sequencing

Other

# of Samples:

Sample Notes:(Required)

Sample Information upload

Accepted file types: xlsx, xls, csv, Max. file size: 24 MB.