Genetic Support Services Deposit Form

Any high risk samples will be disposed of immediately without processing

Please complete the following as fully as possible for each sample deposited with ECACC Genetic Support Services. 
* denotes obligatory fields

Type of Sample: 

Service Required:       

*  Please Note:  ECACC is no longer able to store Depositors samples long term  free of charge.  Blood processing and EBV transformation services includes up to three years storage of ampoules in ECACC's Ultra-low Temperature Storage facility.   After this time the Depositor 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.

A.   Contact Details

B.  Donor Details

C.  Patient Consent
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 permanaent cell line, which will be available to qualified investigators for research, teaching or diagnostic purposes.

ECACC Human Genetic Catalogue:   Please contact us if you are interested in making your samples available  to other researchers via our Human Genetic Catalogue