End User Profile *
End User Profile
SBS/SBS-iTERM PI
SBS/SBS-iTERM Staff
SBS/SBS-iTERM Pg Student
Have you registered to SBS Core Booking System?
Have you registered to SBS Core Booking System?
Yes
No - PLEASE STOP HERE
Name of End User *
CUHK Email *
Lab Tel no. *
Name of PI/Supervisor *
PI/Supervisor's CUHK Email *
APPROVAL DETAILS
Project Title *
Project Start Date
Project Start Date *
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DD
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MM
YYYY
Project End Date
Project End Date *
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DD
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MM
YYYY
1a. Have you obtained a valid Biological Safety Approval for this project? *
1a. Have you obtained a valid Biological Safety Approval for this project?
Yes
No (STOP HERE - PLEASE SEEK APPROVAL FROM UNIVERSITY SAFETY OFFICE)
1b. Please upload your Biological Safety Approval (PDF) for Core reference. *
2a. Have you obtained a Approval from the University Animal Experimentation Ethics Committee, detailing the procedures and specific location to be conducted, the pathogen used and the species of animal to be used.
2a. Have you obtained a Approval from the University Animal Experimentation Ethics Committee, detailing the procedures and specific location to be conducted, the pathogen used and the species of animal to be used.
Yes
No (STOP HERE - PLEASE SEEK APPROVAL FROM UNIVERSITY SAFETY OFFICE)
If stated Yes, you must upload a copy for 2b.
2b. Please upload a copy of your AEEC (PDF) for Core reference.
3a. Have you obtained a valid Animal license from the Department of Health, the license MUST be specific for the type of work (e.g Multiphoton imaging on LIVE animals) and specific location (e.g. LIBSB Room 110) to be conducted
3a. Have you obtained a valid Animal license from the Department of Health, the license MUST be specific for the type of work (e.g Multiphoton imaging on LIVE animals) and specific location (e.g. LIBSB Room 110) to be conducted
Yes
No (STOP HERE - PLEASE SEEK APPROVAL FROM AEEC)
If stated Yes, you must upload a copy for 3b.
3b. Please upload a copy of your Animal License (PDF) for Core reference.
SAMPLE DETAILS
1. Specify Sample source. *
1. Specify Sample source.
a) Fixed Cells
b) LIVE Cells
c) Fixed Tissues
d) LIVE Tissues
e) LIVE Animals
Other, please specify:
Other, please specify:
2. Refer to 1e, please specify species.
Put N/A if not applicable.
3. Please declare the level of Biological Safety materials of your sample source in Q1. *
3. Please declare the level of Biological Safety materials of your sample source in Q1.
BSL-1
BSL-2
Others: please specify
Others: please specify
4. Any human tissue/human pathogen, recombinant DNA or viral/infectious agents involved in your experiment? *
4. Any human tissue/human pathogen, recombinant DNA or viral/infectious agents involved in your experiment?
Yes
No
5. Please provide sample information (source and type). *
6. Please upload the MSDS / PSDS of your sample information for Core reference. *
7a. Are you working with any potential MHV+/infected tissues? *
7a. Are you working with any potential MHV+/infected tissues?
Yes - PLEASE STOP HERE
No
7b. Will you fixed your MHV+/infected tissues prior to imaging? *
7b. Will you fixed your MHV+/infected tissues prior to imaging?
Yes
No - PLEASE STOP HERE
8a. Are your samples Transformed with Virus? *
8a. Are your samples Transformed with Virus?
Yes
No
8b. Please declare the level of Biological Safety materials of your sample sources are transformed with virus in Q8a. *
8b. Please declare the level of Biological Safety materials of your sample sources are transformed with virus in Q8a.
BSL-1
BSL-2
Others: please specify
Others: please specify
8c. Will you fixed your virus-containing samples prior to imaging? *
8c. Will you fixed your virus-containing samples prior to imaging?
Yes
No - PLEASE STOP HERE
8d. Please describe the method for determining no live virus remains in the culture or tissue (eg, there have been at least seven culture passages after infection in the laboratory) before bringing your samples to Core Labs. *
8d. Please describe the method for determining no live virus remains in the culture or tissue (eg, there have been at least seven culture passages after infection in the laboratory) before bringing your samples to Core Labs.
Yes
No
9. Any Oncogen / Toxin expression involved? *
9. Any Oncogen / Toxin expression involved?
Yes
No
If yes, please describe details
If yes, please describe details
SPECIMEN PREPARATION
Please describe your "Experiment procedure in steps". *
If your samples will be fixed, please provide the name of fixative, its concentration and the fixative time. (if LIVE, put N/A) *
BIOLOGICAL WASTE MANAGEMENT:
Please describe the decontamination procedure in steps. *
END USER DECLARATION:
1. Is your corresponding PI well-informed of your sample source(s) that will be performing in your experiment? *
1. Is your corresponding PI well-informed of your sample source(s) that will be performing in your experiment?
Yes
No
2. Have you read our SBS Core Lab - Bio-Safety SOPs, understand the context of the SOPs and will comply with the General Guidelines on Core Facility-Equipment Usage? *
2. Have you read our SBS Core Lab - Bio-Safety SOPs, understand the context of the SOPs and will comply with the General Guidelines on Core Facility-Equipment Usage?
Yes
No
I have read above questions carefully and certify the information provided to be correct.
I certify that my/our research studies will be conducted in compliance with the General Guidelines for Core Facility/Equipment Usage governing the use of bio-hazardous materials, chemicals, radioisotopes, and physical hazards. I certify that all technical and incidental workers involved with my research studies will be aware of potential hazards, the degree of personal risk (if any), and will receive instructions and training on the proper handling and use of bio-hazardous materials, chemicals, radioisotopes, and physical hazards.
A confirmation of the submission form will be forwarded to both End User and corresponding PI.
Signature of PI/End User *