HSCI-CRM Flow Cytometry Core Facility Biosafety Agreement Form
PLEASE READ THIS AGREEMENT PRIOR TO SCHEDULING TIME AT OUR FACILITY. BY PROVIDING YOUR INFORMATION BELOW, YOU AGREE TO ALL TERMS IN THE AGREEMENT:

Our core is multi-user facility where samples from various sources are analyzed and sorted. The safety of our staff and users is our utmost concern. Therefore, accurate information about sample sources, potential infectious agents, and sample preparation procedures is crucial for effective biosafety risk assessment. Failure to fully disclose important biosafety information may result in permanent denial of services.

All unfixed primary human samples, whether tested or untested, from a donor bank or directly from the OR, must be run on the FACSAria3 under BSL2+ conditions in our designated BSL2+ sorting room. You must meet with us and provide additional documentation prior to scheduling appointments for these samples. Please refer to our website or email us for those forms.

All normal, unfixed human cell lines that are not otherwise considered BSL2 may only be run on the FACSAria1 and FACSAria3 in their biosafety cabinets. You must meet with us prior to running these samples, and you must provide documentation stating that these cells have been tested and found negative for HIV, HepB, and HepC, and are not otherwise infectious.

You may not run any BSL3/4 or radioactive samples on any of our machines.

Name *
Your answer
Email *
Your answer
Phone
Your answer
Principal Investigator *
Your answer
Institution *
Your answer
Department *
Your answer
Lab Address
Your answer
Please choose one of the following options: *
Please list all applicable Partners Biosafety Registration numbers (if you chose option 1 above, please just write "NA"): *
Your answer
If you will work with human cells, or cells that otherwise present a biohazard, you must meet with us prior to running samples and provide us with appropriate documentation ASAP. *
USER/PI ACKNOWLEDGEMENT: My PI is aware of my use of this facility, and we understand that failure to fully disclose important biosafety information may result in permanent denial of services. *
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