CBIPM Data and Specimen Inquiry Form

Please review the instructions before submitting.


  • This form is not HIPAA compliant please do not submit any PHI (MRNS, DoB, Names, etc.). If you need to share PHI, please email CBIPM_Biobank@mssm.edu.



  • For all other CBIPM data and/or sample requests, you must have an IRB approved protocol or IRB exempt letter to gain access. Do not submit an inquiry form asking for data and or specimens if you don't have one of these documents as the CBIPM Steering Committee will not be able to process your request.


  • All requests are reviewed by the Charles Bronfman Institute for Personalized Medicine (CBIPM) Steering Committee, and you must receive approval from the committee prior to getting any data and/or samples.


  • Your IRB approved protocol must clearly state the below items. If your approved protocol does not clearly state the below items, you will need to amend your protocol.
  • CBIPM biorepository you wish to access (ex. BioMe Biobank or Mount Sinai Million)
  • Study population (ex. BioMe participants who have X variant and Y disease)
  • Data fields you need for your research
  • Data analysis that you will perform
  • Data security measures you have in place


If you are a Visiting Scientist:


  • Please have your visiting scientist agreement ready to submit.


If you are an External Collaborator:


  • All external collaborations need to have an agreement through Mount Sinai Innovation Partners (MSIP). If you have any questions, please contact Inna Khartchenko (Inna.Khartchenko@mssm.edu).


CBIPM Repositories


  • BioMe Biobank - a biorepository of over 65,000 participants that includes DNA and plasma samples from a single time point and genomic and phenotypic data.
  • Mount Sinai Million - a biorepository that will include genomic and phenotypic data and DNA samples on 1,000,000 participants (both pediatric and adult participants). This study is still in progress with an anticipated completion date of 2028. Additional data and specimens will be made available in Q2 and Q4 of each year.


If you have any questions, please reach out to CBIPM_Biobank@mssm.edu

Requester Information

Request Details

Request Type*

If you have multiple requests, please submit a new inquiry form for each request.

Mount Sinai Million//BioMe Data Anouncement

We are combining the BioMe and Mount Sinai Million Datasets.


The newly named Mount Sinai Million Clinical Genomic Database will be hosted on the Data Ark and will link genetic data to de-identified electronic medical record data for all Mount Sinai Million participants. The Database is inclusive of the data generated from the BioMe Biobank program, which was expanded into Mount Sinai Million in 2022. Currently, the Database includes data from approximately 60,000 participants.


Please visit the DataArk site for information on how to request access to these data.


Only complete this form if you are requesting identifiable data, if the Data Ark dataset does not meet your needs, and/or if you need specimens.

Are you requesting PHI?*

Select all that apply.

De-Identified Dataset Linkage: CBIPM charges a rate of $51/hour to act as an honest broker. All requests will have a minimum charge for 4 hours ($204).

Does Everyone Who Requires Genetic Data Have an HPC Minerva Account?*

If you or your study team does not have an HPC Minerva Account, please request an account through HPC.


Please note: We will not be able to provide access to genetic data if you do not have an HPC Minerva Account.

  1. First and last name(s)
  2. Email address(es)
  3. Minerva ID(s)

Select all that apply.

Mount Sinai Million Samples will be available in 2025.

Please select all personnel that would work on the study/project.

Is this request for an upcoming grant submission?*

We will do our best to review, approve, and fulfill your request in time for your grant submission.

Do you plan to use the data you receive to recall the participants?*

If you plan to do use the data you receive to recall participants, please fill out to the Precision Clinical Research Unit (PCRU) Request form

Are you using federal funds to pay for the samples requested?*
Is this request for a collaboration with industry?*
Are you sharing/do you plan to share results with a consortium?*

Please provide the name of the consortium and any details relevant to the consortium (ex. website)

Are you or the individual(s) you are submitting for listed on the MSCIC protocol?*

If you are unsure what the MSCIC protocol is, please select 'No'

Are you or the individual(s) you are submitting for using the MSCIC protocol to access data for this request?*

If you are requesting data under a different IRB protocol, please select 'No'

Will you be using a third party platform to analyze, deposit, or store the data for this request? (ex. LLMs)*
Has the the third-party platform been reviewed by Mount Sinai IT Security?*

Please note that we cannot grant access to data for use on third-party platforms without an approved Mount Sinai IT Security Assessment.


Please reach out to CBIPM_Biobank@mssm.edu before submitting this form.

Please attach the approved Mount Sinai IT Security Assessment for this third-party platform at the end of the form.

If Mount Sinai Personnel, please list RUTH study ID in the form of STUDY-XX-XXXXX

Cohort Details

Please fill out the fields below with as much information about your desired cohort as you can. The more specific details you provide, the faster we can get you what you are asking for.

Please provide the number of samples you need and/or how many individuals you need data for. If you do not know, you may leave this field blank.


Please note that we share only the minimum data necessary to complete your request so we rarely give access to an entire dataset.

Please provide all necessary inclusion criteria for your request (ex. ICD 10 codes, participant demographics, genetic/self reported ancestry, age, sex, etc.)

Please provide all necessary exclusion criteria for your request (ex. ICD 10 codes, participant demographics, genetic/self reported ancestry, age, sex, etc.)

Let us know if there is a specific date range for the data you are requesting.


If the samples you are requesting need to be collected by a certain date or within a certain time period from the diagnosis date, please provide those details here.

Please provide a list of variables you require for this request. If it is easier, you may attach a .csv or document that lists exactly what you need.


Please note: This form is not HIPAA compliant please do not submit any PHI (MRNS, DoB, Names, etc.). If you need to share PHI, please email CBIPM_Biobank@mssm.edu.


Please note: we are only able to share what's been approved in your protocol.

Please describe the work that you plan to do. In order to reduce the time it takes to fulfill your request, please provide an analysis plan or as much detail as you can.

Do you have a volunteer services/visiting scientist agreement?*
Do you have an approved IRB protocol, HRP-503 (IRB-approved), or IRB exempt determination letter?*

If you're listed on the MSCIC protocol, please select "No"

Would you like to add any additional documents?

This form is not HIPAA compliant please do not submit any PHI (MRNS, DoB, Names, etc.). If you need to share PHI, please email CBIPM_Biobank@mssm.edu.


Please attach the IRB Study Personnel List and one of the following:

  • IRB approved protocol (stamped)
  • IRB HRP-503 form


If you are a visiting scientist, please attach the following:

  • Visiting scientist agreement


If you are requesting to share data with an external party (consortium, industry partner, academic institution), please attach the following:

  • Fully executed agreement with MSIP


If there are any other documents that you think may help us better understand your request, you may attach them here as well.

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