Request For Tissue

Researchers can request brain tissue samples from the Brain Bank PGIMER to advance their studies in neuroscience and neurological disorders.

How to Request
Available Resources:

Application Process: Fill out our Request Form with detailed information about your research project.
Approval Timeline: Expect processing times and instructions for receiving tissues.

Tissue samples categorized by diagnosis, preservation type, and demographic information.

Form A

REQUEST FOR POSTMORTEM BRAIN TISSUE / TISSUE FLUID from HUMAN BRAIN TISSUE REPOSITORY (HUMAN BRAIN BANK)
Histopathology, PGIMER, Chandigarh

Name of the Principal Investigator

Title of the Project

Funding Agency

Summary of the project justifying the use of human brain tissue / tissue fluid.

Type of sample required, specifying the conditions to be satisfied during procurement, processing, storage

Sample Required

Quantity/Units

Indicate clinical details required along with the sample, like clinical laboratory findings, treatment received and final diagnosis, etc.

This work has been approved by local Institutional Human Tissue Use/Ethics Committee

Form B

Provider

The Provider agrees to transfer to Recipient Scientist the following Research Material
Research Material

Which is Classified asIdentifiable: samples or data that are still attached to a readily available subject identifier such as a name, telephone number, address, email ID, medical record numberCoded: collected samples or data that are unidentified for research purposes by use of a random or arbitrary alphanumeric code but that may still be linked to their sources through use of a key to the code available to an investigator or collaborator (E.g.: Provider Scientist)Anonimized: human data or samples that were initially collected with identifiers, but stripped of all identifiers by use of an arbitrary or random alphanumeric code and the key to the code is destroyed, thus making it impossible for anyone to link the samples to the sources. This does not preclude linkage with existing clinical, pathological, and demographic information before subject identifiers were removed

Title

Approved By

Protocol Approval Number

Approval Date

Copy of IRB Approval

This Material may not be used in HUMAN SUBJECTS

RECIPIENT AGREEMENT
Human Subject Protection: In order to respect the privacy of the human subjects, the Recipient agrees that it will not contact or many an efforts to identify individuals, families, communities, castes, or sects which are or may be sources of the Research Materials.The Recipient agrees to use the Material in compliance with all applicable regulations set by the State and Ethics Committee of his/her Institution.The Material is provided at no cost, or with an optional transmittal fee solely to reimburse the Provider for its preparation and distribution costs. If fee is requested, the amount will be indicated here Rs……………………..The Recipient and the Recipient Institution should sign both copies of this letter and return one signed copy to the Provider Scientist. The Provider will then forward the Material upon receipt of the copies.This Research Material represents a significant investment on the part of Provider and is considered proprietary of Provider. This research material will not be transferred to other people not under her or his direct supervision without advance written approval by the Provider. The Provider reserves the rights to distribute the Material to others and to use for its own purposes. When the Research project is completed or three (3) years have elapsed, whichever occurs first, the Material will be disposed of as directed by the Provider. Incase the same material is planned to be used for further research purposes other than the specified, the provider needs to be informed and the investigator should seek fresh ethical clearance for the proposed project.This Research Material is provided as a service to the research community.

IT IS BEING SUPPLIED TO THE RECIPIENT WITH NO WARRANTIES, EXPRESS OR IMPLIED, OR FOR COMMERCIAL PURPOSES

Provider Scientist

Recipient

Recipient Organization