Name of establishment to be licensed Address of establishment to be licensed Postcode: Please provide names of the proposed Persons Designated for the licence if the establishment is applying for a licence on one premises Activities to be licensed Section 16(2)(e)(ii) - The storage of relevant material which has come under the Human Tissue from a human body for use for a scheduled purpose, other than Act 2004 transplantation Activities to be licensed Procurement under the Human Tissue (Quality and Safety for Testing Human Application) Regulations 2007 Processing - If you are applying to undertake Processing activity please also complete a Preparation Process Dossier by clicking . Storage Distribution Import Export What tissues and/or cells Pericardium are procured, tested, processed, stored, Arterial vessels distributed, imported and exported? Other cardiovascular Bone Stem Cell Lines Tendons Meniscus Skin Cornea Sclera
Name of establishment to be licensed Address of establishment to be licensed Postcode: Please provide names of the proposed Persons Designated for the licence if the establishment is applying for a licence on one premises Activities to be licensed under the Human Tissue Act 2004 Section 16(2)(e)(ii) - The storage of relevant material which has come from a human body for use for a scheduled purpose, other than transplantation Activities to be licensed under the Human Tissue (Quality and Safety for Human Application) Regulations 2007 Procurement Testing Processing - If you are applying to undertake Processing activity please also complete a Preparation Process Dossier by clicking . Storage Distribution Import Export What tissues and/or cells are procured, tested, processed, stored, distributed, imported and exported? Pericardium Arterial vessels Other cardiovascular Bone Stem Cell Lines Tendons Meniscus Skin Cornea Sclera
Human_Application_Licence_Application_Form_Updated_June_2014_0.docx