Submission Date* must provide value
Today M-D-Y
Application Type* must provide value
Initial application for this study/project Amended biorepository application for this study/project
Your Study/Project SPARC Request Number* must provide value
Please select the reason(s) for your amendment from the list below* must provide value
Change to sample type and/or quantity Other/Additional Notes
Please indicate the other reason for your study/project amendment and/or enter your notes here* must provide value
Please note that any changes to your request might require additional approvals Project Synopsis or Specific Aims (protocol if available)* must provide value
Study/Project Anticipated Start Date* must provide value
Today M-D-Y
Who is the contact regarding this application?* must provide value
Principal Investigator
Other
As the contact, please enter your name, position, email address and telephone number in the fields that follow: Your full name* must provide value
Your position* must provide value
Your email address* must provide value
Your telephone number* must provide value
PI First Name* must provide value
PI Last Name* must provide value
PI Affiliation* must provide value
MUSC
Clemson
Other
Other PI Affiliation* must provide value
PI MUSC College Affiliation* must provide value
College of Medicine
College of Nursing
College of Health Professions
College of Dental Medicine
College of Pharmacy
College of Graduate Studies
Academic Affairs Faculty
PI College of Medicine Department* must provide value
PI Email Address* must provide value
PI Telephone Number* must provide value
Study/Project Title* must provide value
Funding Status* must provide value
Funded
Pending Funding
Funding Source* must provide value
College Department Federal Industry-initiated/industry-sponsored Investigator- initiated /industry- sponsored Internal funded pilot/ project Student funded research
Research Master ID (RMID) (if available)
MUSC has established a COVID-19 biorepository that includes samples from patients known to be COVID-19 positive and negative. The samples include DNA/RNA, serum, plasma, saliva, PBMCs used for testing, as well as longitudinal samples from convalescent patients. To request samples from the biorepository, please enter the information requested below. Requests will be reviewed on a rolling basis by the oversight committee. Please direct any questions to Amy Gandy. Also please refer to the Institutional Biosafety Committee (IBC) Guidance for information about requirements for IBC safety committee approvals.
Note: The SCTR Biorepository and SCTR Research Nexus Lab are BSL-2+ certified research labs approved to handle COVID-19 samples. If you plan to use your own lab for COVID-19 samples, please contact Michael Smith, IBC Program Manager to determine the requirements. Contact information can be found at: https://research.musc.edu/resources/ori/ibc
Does the study/project involve using existing biorepository lab samples in alignment with the collection schedule above? * must provide value
Yes
No
If you are planning to use the Nexus Lab, please submit a SPARC Nexus Lab Consult [https://sparc.musc.edu ] prior to submitting for funding to determine feasibility.
Select the type(s) of samples you will require :* must provide value
DNA
RNA
Serum
Plasma
Saliva
PBMC
Using the table shown above as a guide, list the quantity of DNA you are requesting per time point here* must provide value
Using the table shown above as a guide, list the quantity of RNA you are requesting per time point here* must provide value
Using the table shown above as a guide, list the quantity of serum you are requesting per time point here* must provide value
Using the table shown above as a guide, list the quantity of plasma you are requesting per time point here* must provide value
Using the table shown above as a guide, list the quantity of saliva you are requesting per time point here* must provide value
Using the table shown above as a guide, list the quantity of PBMC you are requesting per time point here* must provide value
Will you be requesting associated clinical data for the biorepository samples?
* must provide value
Yes
No
Based on your responses above, you are required to complete a Biorepository Consultation. This request will be made on your behalf through SPARC. If you have any questions, please contact the SUCCESS Center (succcess@musc.edu). Additional notes regarding your biorepository sample request
Biorepository Staff Notes
Other additional information you would like to provide (optional):
I understand that any changes to my application may require additional approvals, and that it is my responsibility to ensure my study/project complies with any applicable regulations. Failure to do so may result in delaying the start of this study/project and/or fulfillment of this request.' Note: For regulatory assistance contact the SUCCESS Center, success@musc.edu .
* must provide value
Thank you for completing this application. You will be contacted if additional information is required and when the Biorepository committee(s) have completed their review. Please contact Amy Gandy, gandya@musc.edu, if you have any questions. Please note that you will have an opportunity to download a PDF of this completed survey once you click the 'Submit' button.
Leadership Determination Approve Disapprove
Leadership notes
Decision Date
Today M-D-Y
Determination sent to PI? Yes
No
Date sent
Today M-D-Y