Histology Laboratory Service Order Form 2012-2013

USC School of Pharmacy

Please submit the order form to Dr. Lina He at PSC 402B; for questions:

Submitted By: ______

Contact Phone:______

P.I.:______

School/Dept:______

Contact Email:______

Account #:______

Type of Tissue:______

Total Tissue Samples:______

Sample ID Number:______

Section Thickness:______

H&E Staining:______

Number of Slides per Sample:______

Total Number of Slides:______

Other Instructions:______

______

Below for Histology Laboratory use only:

USC Non-Pharmacy Rate
Service / Rate / Unit / Units / Charges
Processing & embedding / $7/cassette
Paraffin sectioning 1st slide / $3/slide
Paraffin sectioning additional slide / $1.5/slide
Frozen sectioning 1st slide / $10/slide
Frozen sectioning additional slide / $2/slide
H&E staining / $1.5/slide
Microm HM310 rotary microtome usage
(book via lab online scheduler listed below)
Slides (including blades) / $30/hour / $3,000/year
$1.00/slide
Microm HM525 cryostat usage
(book via lab online scheduler listed below)
Slides (including blades) / $30/hour / $3,000/year
$1.50/slide
Slide folder (25 slides) / $8/Folder
Slide folder (100 slides) / $12/Folder
Consultation & Training / $40/hour
TOTAL
Lab Location: 1985 Zonal Avenue, PSC 402B; Phone: 323-442-2157
Lab Webpage: http://pharmacyresearch.usc.edu/core-facilities/histology-lab/
Lab Online Scheduler: http://www.uburst.com/cgi-bin/ureserve/hosted/usc.pl /

Date Received:______

Date Completed:______

Lab Location: 1985 Zonal Avenue, PSC 402B; Phone: 323-442-2157
Lab Webpage: http://pharmacyresearch.usc.edu/core-facilities/histology-lab/
Lab Online Scheduler: http://www.uburst.com/cgi-bin/ureserve/hosted/usc.pl /
Lab Location: 1985 Zonal Avenue, PSC 402B; Phone: 323-442-2157
Lab Webpage: http://pharmacyresearch.usc.edu/core-facilities/histology-lab/
Lab Online Scheduler: http://www.uburst.com/cgi-bin/ureserve/hosted/usc.pl /