FIU-Baptist Health Biospecimen Request Preclearance Form

This form allows FIU Medicine faculty to request internal preclearance for FIU-Baptist Health biospecimen requests before formally requesting samples from the Baptist Health Biospecimen Repository.

Once submitted, it will be sent to the Biospecimen Research Committee.

Name Name First Last
Email
Explain your research purpose and potential clinical benefit
Maximum of 100 words allowed. Currently Entered: 0 words.
Describe the type of biospecimen needed, the age range of donors and the estimated number of samples. Will sex be considered a biological variable in your research?
Maximum of 100 words allowed. Currently Entered: 0 words.
Explain why tissue or biospecimens are essential for your research compared to alternatives like cell/in vivo models, and justify the number of samples requested.
Maximum of 200 words allowed. Currently Entered: 0 words.