Tissue request Name: Institute: Address: Phone: Telefax: Email: Project title: Summary of the project (a maximum of two pages): By which funds is the project supported? Have you obtained research ethical committee approval for your project? Tissue samples details: Number of tissue samples from patients: Definition of the patient (e.g. "Alzheimer patient with CERAD C and Braak & Braak stage 5-6"): Number of tissue samples from control persons: Definition of the control person (e.g. "age 50-70", "no dementia"): Required brain regions (exact anatomical description):
Tissue request Name: Institute: Address: Phone: Telefax: Email: Project title: Summary of the project (a maximum of two pages): By which funds is the project supported? Have you obtained research ethical committee approval for your project? Tissue samples details: Number of tissue samples from patients: Definition of the patient (e.g. "Alzheimer patient with CERAD C and Braak & Braak stage 5-6"): Number of tissue samples from control persons: Definition of the control person (e.g. "age 50-70", "no dementia"): Required brain regions (exact anatomical description):
nbm-gad-tissue-request-11_2017.docx