Forms

Account Registration

Prior to placing an order with us, we ask that you please fill out and submit the appropriate registration form to provide the necessary contact and billing information:

Core Services Account Registation

For any questions regarding the account set up process please contact our business administrator Lori Delspechio-Irvin at 267-426-7795 or irvin [at] email.chop.edu

New For 2017!

In addition to the account registration all external customers (Not CHOP or UPENN) are required to complete a Research Core Service Agreement Form before work can begin.

Pathology Core Online Specimen Submission Form

In order to drop off specimens for processing, customers must first complete an online submission form (Google document) to begin your order. The submission form can be accessed and filled out ahead of time or you can fill it out in the lab on our customer PC when you drop off your specimens. For access, select the link below:

When you physically drop off your specimens, we will generate a path core number for your particular request and we will print out a copy of the form for you to keep for your records.

The following are field by field guidelines for filling out the online form:

P.I. Name: This is a required field and will dictate the lab that will be billed for the services. Before submitting specimens, P.I.'s should register their lab with the CHOP business office as a pathology core user. Here is a link to the registration form and instructions:

P.I. Account Number: This is a required field and will dictate the PO or grant number that the job is billed to. Most of our PI's have multiple accounts for different projects so we need to know which account you want us to charge for each job that we complete. We need to have the account information at the time the specimens are submitted in order for us to enter the job into the queue.

Dropped off by: Name of the individual who is delivering the specimens. This is also the primary contact if we have questions or to notify when the job is complete. 

E-mail Address: e-mail address of the primary contact. We typically send an e-mail when the job has been completed and is ready to pick up.

Phone Number: Phone number of the primary contact. We use this if we need to contact you urgently or you have not responded to e-mail.

Collection Date: Date that the specimen was collected. Not critical for us, but it may help identify specimens if there is a problem with the labeling.

Fixation Type: Typically formalin, but we like to know how the specimens were fixed and the duration of the fixation before we process them.

Fixation Time: The duration of the fixation (see above).

Species: Animal or species of the specimen being submitted.

IRB Protocol Number: We require an approved IRB protocol number before we can process any human tissue in the lab.

Organ: Organ or organs that are being submitted.

Specimen Identification: Unique specimen ID for each cassette or tissue sample. This is how we will label your cassettes, slides, etc.

For human samples please do not use any patient identifiers, i.e. name, birth date, surgical numbers, medical record numbers, etc. as this is a web based form.

Number of Samples: Total number of tissues or samples submitted for that particular job.

Service: Choose a service from the drop down menu.

Quantity: Total number of specimens/slides for that particular service.

Comment: Special instructions for that service such as specimen orientation, sectioning instructions, the special stain(s) or antibody(ies) names, etc.

Rush Charge: This is a yes or no field. The rush charges is three times the standard charge. We process jobs in the order that the specimens are submitted. Our typical turnaround time will range anywhere from 1 week to 3-4 weeks depending on our current workload. Submitting a job as a rush job will move you to the front of the line so your job will be completed before non-rush jobs submitted prior to yours. This typically takes 2-3 days depending on what you are requesting and how many other "rush" jobs we are working on. When you drop off your specimens we can give you an idea of our current turnaround time for standard processing and how quickly we could get your job done if rushed.

Repeat for each service requested.

Comments/Instructions: A final field for overall instructions, requests, comments, etc for the particular job.

When everything has been filled out click on the submit button and your request will be saved. When you drop off your specimens we will pull up your request and assign a unique path core number (job number) for tracking purposes and your job will be entered into the queue.

Top