Flow Cytometry Badge Access Request

Requestor Information

Employee (6-digit) or Student ID (9-digit)*

Last Name*

First Name*

Email*

Title (ex: PRA, student worker, faculty, graduate student)*

Select or enter value

If other, please specify*

Institution*

AMC University of Colorado

AMC Children's Hospital Colorado

AMC UCHealth

Other

Department*

Primary Investigator/ Supervisor Information

PI Last Name*

PI First Name*

PI Email*

Access Request

Will you need the access for at least one year?*

Select or enter value

Access requested location (select all that apply)*

L18 04 Labs (RC1-South, 4th floor labs)

P18 8207 Labs (RC!-North, 8th floor labs)

Reason for access request*

Trained (or in training) to operate FCSR Instrument(s)

Assisted use of FCSR Instrument

FCSR Employee

Do you need to use the FCSR Equipment between the hours of 6PM-6AM or during weekends or holidays?*

Select or enter value

By checking the box below, you affirm that you have completed the required Skillsoft training listed. Completion of training is required for access to Flow Cytometry Shared Resource spaces. The requestor and primary investigator are responsible for ensuring personnel's training is compliant.

• Bloodborne Pathogens

• Chemical Waste Management

• Regulated Medical Waste Management

Acknowledgement

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