Download INSTITUTE OF CHILD HEALTH – Biosafety THE ICH/GOS FLOW CYTOMTERY CORE FACILITY

INSTITUTE OF CHILD HEALTH
THE ICH/GOS FLOW CYTOMTERY CORE FACILITY – Biosafety
Questionnaire for Cell Sorting and Analysis
Please complete and sign the from below and bring it with you to the facility. Please make
sure to update us with any biosafety changes that may happen after your project has
started.
Flow cytometry labs are multi-user facilities where many different samples from various
sources that may contain known or unknown human pathogens are investigated. The
safety of staff and users is of ultimate concern. Information about the sample sources and
potentially infectious agents is critical for effective biosafety measures. Consequently this
sample information form must be filled out completely and signed before experiments
or projects are started. The same biosafety questionnaire will be kept on file provided
none of the information it contains has changed. Appropriate biosafety approval of
experiments prior to sorting is required.
Date
Principal Investigator:
Investigator:
Unit/Department:
ICH users, please provide Grant Code:
UCL users, please provide Grant Code or an IDT:
GOS Hospital and ALL other users, please provide a Purchase Order before EACH
SORT takes place:
Phone no.:
E.mail:
Summary of project
(Details related to sorting experiment)
List type of sample and source
(Mouse spleen/human lymphs/cell line with origin)
Does the sample contain any known infectious agents?
UCL Institute of Child Health
30 Guilford Street, London WC1N 1EH
Tel: +44 (0)20 7242 9789 Fax: +44 (0)20 7829 8689
[email protected] www.ich.ucl.ac.uk
UCL Institute of Child Health in
partnership with Great Ormond Street
Hospital for Children NHS Trust
The child first and always
Has the infectious agent been inactivated?
Were blood cells screened for bloodbourne pathogens?
Could the sample contain any other known human pathogens?
Were the cells transformed using a virus?
(List viruses)
Were the cells genetically engineered?
(How were they genetically engineered)
Have the cells been tested for mycoplasma infection?
Will the samples be fixed prior to sorting?
I have read the questions carefully and certify the information provide to be correct
______________________________
Signature
UCL Institute of Child Health
30 Guilford Street, London WC1N 1EH
Tel: +44 (0)20 7242 9789 Fax: +44 (0)20 7829 8689
[email protected] www.ich.ucl.ac.uk
UCL Institute of Child Health in
partnership with Great Ormond Street
Hospital for Children NHS Trust
The child first and always