Biobank Forms

The following form is used in the Biobank FMPHN UGM, which can be downloaded below:

ALIQUOTS

ALIQUOTS FORM is a request form for an aliquot on a sample. This form is filled in by the PI/Researcher.

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SAMPLE EXTERMINATION REPORT

SAMPLE EXTERMINATION REPORT is a report from Biobank FMPHN UGM that the relevant sample has been destroyed. This report is submitted to the researcher/client entitled to the sample.

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CONTRACT

CONTRACT is an agreement between Biobank FMPHN UGM and a client/researcher to carry out the process of managing biospecimen and related data.

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MATERIAL DELIVERY AGREEMENT

MATERIAL DELIVERY AGREEMENT is an agreement between Biobank FMPHN UGM and a client/researcher who was contracted to manage biospecimen to deliver material.

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SAMPLE WITHDRAWAL

SAMPLE WITHDRAWAL contains a list of samples to be withdrawn from the biobank by the PI/researcher (Form that makes the researcher).

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SAMPLING

The SAMPLING FORM contains a list of samples to be withdrawn from the biobank by the PI/researcher (Form that makes the researcher).

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PROJECT PROGRESS REPORT

PROJECT PROGRESS REPORT is a report that contains additions and/or reductions in data and biosamples stored in the Biobank FMPHN UGM on a regular basis (monthly and yearly).

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LOG SAMPLE 1

LOG SAMPLE 1 to record patient demographic data (name, date of birth, medical record number, address, clinical condition).

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LOG SAMPLE 2

LOG SAMPLE 2 to record biosample transactions from sampling, temporary storage (if needed), and time of arrival at Biobank FMPHN UGM.

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LOG SAMPLE 3

LOG SAMPLE 3 to record processing time from centrifugation (if needed) to storage in the Freezer -80C, including the temperature and speed used.

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The file is password-protected. To download/access the file above, please get in touch with the Biobank Admin: Mrs. F. Linda Tri (linda.tri.p@ugm.ac.id)