TDAAC Histology Service Request Form

How many shavings do you need/sample?*

Desired thickness (um) of shavings*

Are you submitting samples in frozen blocks?*

i.e. Samples are frozen and embedded in OCT/similar matrix

Yes

No

How are you submitting your samples?*

Frozen, but not embedded

Samples are not frozen

Samples cryopreserved with sucrose?*

Yes

No

Please describe how the samples were frozen.*

How would you like your sample grossed?*

i.e. special instructions for grossing

When were your samples fixed?*

Number of tissues to be grossed?*

Other fixative used*

Other fixative/buffer samples stored in?*

Are your samples already in cassettes?*

yes

no

How many samples need to be processed & embedded?*

Any special processing requests? If yes, describe*

Please describe how you want the samples embedded.*

(specific orientation requests)

Are you submitting samples already in blocks?*

yes

no

Number of paraffin blocks submitting?*

How many unstained slides per sample do you want?*

Please only indicate the number of unstained slides you would like. If you are also doing H&E, IHC/IF, mIF, or mISH the slide count sectioned will be included in those sections below.

How many sections per slide do you want?*

(additional charge for greater than 2 secitons/slide)

What is your desired section thickness (um)?*

How many H&E slides stained per sample?*

Is there a specific slide you want stained for H&E*

e.g. the 3rd slide cut out of 6 (1st slides is the first sections cut)

Is there specific slide to be stained for IHC/IF*

e.g. the 3rd slide cut out of 6 (1st slides is the first sections cut)

Do you want the staining to be IHC or IF?*

IHC

IF

What antibody(ies) do you want used for IHC or IF?*

Will your staining need to be optimized?*

Please see the list of optimized antibodies here. If the antibody is not listed please select yes, optimization is necessary.

yes

no

Will your lab provide the antibody for IHC/IF?*

yes

no

Any specific instructions for IHC/IF?

Is there a specific slide to be stained for mIF?*

e.g. the 3rd slide cut out of 6 (1st slides is the first sections cut)

What mIF panel would you like?*

Human immune panel -1 (CD3, CD8, FOXP3, granzyme B, CD45R, Pan-Cytokeratin)

Human immune panel -2 (CD3, CD8, FOXP3, granzyme B, CD45R, PDL1, Pan-cytokeratin)

Human immune panel-3 (CD8, CD68, PDL, PDL1, FOXP3, Pan-cytokeratin)

Mouse immune panel-1 (CD4, CD8, FOXP3, CD11b, GR1, pan-cytokeratin)

Mouse immune panel-2 ( F4/80, CD80, Arginase, GR1, CD11b, pan-cytokeratin)

Other- need consultation

Is there a specific slide to be stained for ISH?*

e.g. the 3rd slide cut out of 6 (1st slides is the first sections cut)

What probes will you use for ISH?*

Please include which fluorophore you would like paired with each probe.

What is the total number of slides that will be submitted for imaging?*

What type of imagining would you like?*

Select or enter value

What magnification would you like?*

Note: Higher magnification creates larger files

10X

20X

40X

Is the slide a TMA?*

yes

no

What fluorophores did you use for your IF?*

Do you want to select regions of interest to perform digital quantification??

Select

How many of each consumables do you need?*