NON-HUMAN SAMPLES (PRIMATE SAMPLES NOT ACCEPTED) 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the 'Project/request' field with a brief description of your research project.
3. Enter the investigator's name, department, and campus mail information in the designated fields.
4. If there is a different contact person, provide their details including phone, fax, and email.
5. Complete the billing instructions section by entering the COA# and any other necessary information requiring Lab Medicine approval.
6. In the 'PROJECT DESCRIPTION' section, specify the duration of your project along with start and end dates.
7. List the tests or services requested. If needed, attach additional documentation for clarity.
8. Indicate sample types and total numbers for both samples and tests required.
9. Specify any special handling or delivery requirements as well as sample processing preferences.
10. Finally, ensure all sections are completed before submitting via email or fax as instructed at the bottom of the form.

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