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REQUEST FOR TRAINING FORM - INTERNAL

Core Electron Microscopy Facility
Department of Cell and Developmental Biology
University of Massachusetts Medical School
55 Lake Avenue North
Worcester, MA 01655\Phone: (508) 856-2602

REQUEST FOR TRAINING FORM - INTERNAL

Type of Request

PLEASE NOTE: Module I training is required for Module II unless applicant has substantial previous EM experience and is pre-approved by the staff to be eligible for Module II.

Biosafety (must be completed regarding future work in the facility)

Is recombinant DNA found in this sample?
Is this sample derived from any pathogen, or cells or tissues infected with a pathogen?
If any of the answers above is yes, what is the risk group:

See ABSA: http://www.absa.org/riskgroups/index.html

Is this sample human tissue? (Including blood or blood products)
What biocontainment level is necessary?
If any of the answers above are “Yes,” does Submitting PI have IBC approval?

Instructions To Submit a Copy of Your Institutional IBC Approval

Please e-mail a copy of your institutional IBC approval, if applicable, letter to:
(should indicate the biocontainment requirements)

Gregory.Hendricks@ umassmed.edu

For human tissues or pathogens coming from outside UMMS, we require that the samples be fixed before shipping to the lab to inactivate any pathogens.