Core Facilities Services Request Form

Core Facilities Service Request Form

Note: This form is intended for researchers seeking the services of a Mayo Clinic core laboratory. Patient inquiries should be directed to the Mayo Clinic appointment request page. Please do not share any type of patient information.

Complete the form to request core research services.

Your information

Name:

Email:

Phone number:

Organization:

(Optional)

Your country:

(Optional)

Scientific question, objective or describe consultation needed:

Your needs

Sample type, quantity, condition and any handling constraints (if applicable):

Desired data type, assay, platform or analysis, if known (if applicable):

Timeline, grant deadline or other scheduling considerations (if applicable):

Budget source, estimate needs or proposal requirements (if applicable):

Any routing, shipping or collaboration needs (if applicable):

After submitting your request, do not leave this form until you see the confirmation message.

Core Facilities Services Request Form

Core Facilities Service Request Form

Mayo Clinic Number

In correspondence:

In pre-appointment questionnaires

In medical documents:

In dismissal summaries:

In several other kinds of documents:

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