Histology Services Request Form

Updated 1/13/21

Requester Information

Requester Information

Last Name *

Please enter Last Name of submitter

First Name *

Please enter First Name of submitter

Email Address *

PI Last Name *

Please enter Last name of the lab PI

Is this an Internal or External Request? *

Internal (Sanford)

Academic/Non-Profit

External

Services Required

Services Required

Do you need a quote?

Yes

No

Do you need paraffin embedding? *

Yes

No

Do you need tissue sectioning? *

Yes

No

Do you need Special Stains? *

Yes

No

Do you need H & E Staining? *

Yes

No

Do you need IHC? *

Yes

No

Do you want Immunofluoresence?

We can currently support up to two colors

Yes

No

General Comments

*

Send me a copy of my responses