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Website: cgs.hku.hkContact Person: Mandy Tang / Tsztung Ng / Wystan Zeng / Rachel LiEmail: [email protected] No: 2831-5477 / 2831-5467Order No.: GA- ______________________________________
Genetic Analysis Service Request Form
User InformationP.I. Email:
User Name:P.I. Name: Project Name/ID:
User Email:
Billing Address:- - - - -
Department:
User Contact No.: Fax:
Signature:
Billing Account:
Sample Submission Date (yyyy-mm-dd):
Type of Services
ABI BigDye v3.1
Reaction, Purification & Run (in 15µL) (Qty:________________)
Full service:
Purification & Run (in 20µL) (Qty:________________)
* Protect cycle sequencing products from light
Sample Information
Source of genomic DNA: Plasmid PCR Product
Others:_________________________
Sample Storage: RT 4°C -20°C -80°C
Biohazard Samples: Yes No
Note
* Refer to CGS website (cgs.hku.hk) for CGS Primer Sequence and other detailed submission information - All colored samples are unacceptable - We DO NOT accept any sample with potential biohazard - We DO NOT recommend samples with coloured dye
- Use appropriate vessels for sample submission: Sample # 1 - 7 : 0.2 mL microtubes # 8 - 32 : 8-well strip tubes # 33 - 90 : 96-well plate (leave 6 empty wells for run controls) (place samples in the order of A1-H1 ->A2-H2 and so on)
- Label and print clearly (unclear information will cause delayed processing) - Submit all samples in a plastic bag with clear identification information - For Research Use Only. Not for use in diagnostic procedures - For personal data protection, please be reminded that the submitted sample IDsshould NOT carry any personal information such as the HKID or passport numbers, thelaboratory numbers of patient reports, or the patient IDs of hospitals.- Please refer to the Privacy and Personal Data Protection Policies at http://cgs.hku.hk/portal/index.php/policies for information on personal data protection and handling byCGS.
Fill in ALL information below:
Sample Name (Max. 8 characters on hardcopy)
(No SPACE within name)
Expectedread length
(bp)
1
2
3
4
5
6
7
8
For more than 8 samples, submit "Sample Information File". Spreadsheettemplate available online from CGS website (cgs.hku.hk). Submit ahardcopy as well as email the file to [email protected].
Sign Date Remarks
Courier Collection box at FMB / QM / SBS
Gel photo(s) Sample list (hardcopy) Sample list (email)
Sample received by :For Official Use
Sign Date RemarksSample Tracking
Result Delivery
Database input
Additional Remarks:
Result Delivery - rerun
Sequencing Purification
Sequencing ReactionNotify user sample received
Run - Plate ID:
Rerun Plate ID
100-200 bp
200-500 bp500-1000 bp
1000-2000 bp
>2000 bp
PCRProduct
2000 - 3000Bacterial genomic DNA
DNA Amount (ng)
20 - 50
3 - 10
10 - 40
1 - 3
500 - 1000Cosmid, BAC
150 - 300ds DNA, plasmid
5 - 20
25 - 50ss DNA
Top up to 14uL with water (DNase free)Add 1ul of 5uM sequencing primer
Unit price
Payment (For Official Use)
Qty Sub total (HK$)Service Options
Total:
QA/QC Supervisor: Date:
Date:Job done by:
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