Application for Biospecimen Collection

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Application for Biospecimen Collection


  1. Decide if you want to obtain human biospecimens from the BTRF as anonymous, coded-linked or identified specimens. This will dictate the type of IRB approval under which the research is conducted. If you receive anonymous samples, this is not considered human subjects research, and UVA policy is that you do not need to apply for any IRB review (skip to Step 3). Please understand that for anonymous (de-identified) samples you cannot get additional clinical information once you receive the samples, you cannot get additional material from the same subject, and you cannot be assured that other samples you receive from the BTRF do not belong to the same individual, because the BTRF keeps no records of the donors' identities for anonymous specimens.
  2. If you wish to receive coded-linked or identified human biospecimens, you must obtain an approved protocol for your research project from the Institutional Review Board for Health Sciences Research . If you wish to receive coded-linked specimens, where the BTRF maintains a link to subject identity but will not release this information to specimen recipients, our IRB will usually grant expedited review. For instructions on how to file such an application with the UVA IRB-HSC, click here. Send a copy of the IRB review to the address given below.  Collection or distribution of tissue will not occur until this documentation is provided!
  3. Obtain the appropriate training, approval, equipment and supplies to work with human tissue and or fluids. See the Biosafety Committee web-page for more information.
  4. Complete the application form. Please consider your needs carefully. The larger the specimen aliquot that you request, and the more strict the conditions that you specify, the greater the difficulty we have in fulfilling your request. Please feel free to discuss your requirements with the the Biorepository Manager or the Faculty Director (see Contacts ). Send the form to the Biorepository Manager:

                            Craig Rumpel
                            Dept. of Pathology
                            P.O. Box 800904 
                            Ph. 982-6453 PIC#6551 email: crumpel@virginia.edu  

Mr. Rumpel's office is in the basement of the Carter-Harrison Medical Research Building (MR6), Rm. B705A

By completing the application and initiating your request, you indicate that you understand and will comply with the following conditions:

  1. You will comply with the provisions of the IRB approval regarding human subjects research.
  2. The Biorepository does not screen samples or subjects for any type of infections, and therefore the researchers and all laboratory personnel should observe universal precautions. You must understand that in receiving anonymous or coded-linked samples, subject identity cannot or will not be disclosed even in the event of exposure of laboratory personnel to potentially infectious material. It is assumed the investigator adheres to all University of Virginia policies and procedures regulations regarding biohazardous materials, including the appropriate training of, and notification of risk to, all personnel exposed to these materials.
  3. All University of Virginia policies and procedures regarding transfer of material to a third party apply to these biospecimens. The transfer of coded-linked and/or identified human materials to individuals or entities not authorized by the IRB-HSR is a violation of Federal Law.
  4. You will reimburse the BTRF according to the published fee structure for materials and services that you receive.
  5. To justify the investment by UVA in this facility, you must agree to acknowledge the contribution of the Biorepository and Tissue Research Facility in any publications arising from the use of these samples. We also request that a copy of the manuscript(s) be sent to us upon publication.