Cell Line Registry
Please complete the form for each cell line to be used.
This form is not necessary if the cell line is already on the APPROVED CELL LINE list. To verify, please click
[here]
.
Please contact Ty Hoover (
tchoover@mdanderson.org
) if you have any questions or need further assistance.
Protocol Number (if applicable)
Department
Investigator Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
E-mail
Alternate Contact Name
First Name
Last Name
Alternate Contact Phone Number
-
Area Code
Phone Number
Cell Line Name
*
Cell Line Aliases
Original Source
*
Human
Non-Human
Unknown
Cell Line Type
*
Adult
Embryonic
Unknown
Donor Status
*
Deceased
Living
Unknown
Tissue of Origin Type
*
Neoplastic
Non-Neoplastic
Unknown
Tissue Type
*
(e.g., breast, GI, blood, unknown, etc)
Where did you obtain this cell line?
*
(i.e., institution, company, etc.)
If cell line is commercially availabe, list vendor. (Enter N/A if none)
*
To review commercial vendor list, please click [here].
Is the cell line you are receiving associated with any information that would allow donor identification?
*
Yes
No
Unkown
Is there a link that will allow the user/recipient to identify donor?
*
Yes
No
Unkown
References
(known references / publications describing cell line)
MDACC Cell Line Recipient(s)
Submit Form
Should be Empty: