Build a quick budget
Submit a request
Build a quick budget
Submit a request
Will these samples be used for any type of genetic sequencing?
* must provide value
Yes
No
Thank you for inquiring about our Biorepository. Unfortunately, we are not equipped to provide samples for genetic use at this time Do any of these apply to you?
- Will the results of the specimen analysis be published?
- Will the results of the specimen analysis be disclosed outside of your laboratory, such as in a presentation in a scientific lecture?
- Will you maintain records of the specimen analysis to be used in later studies?
- Are the samples being collected for any purpose other than validation of a laboratory test?
* must provide value
Do any of these apply to you?
- Will the results of the specimen analysis be published?
- Will the results of the specimen analysis be disclosed outside of your laboratory, such as in a presentation in a scientific lecture?
- Will you maintain records of the specimen analysis to be used in later studies?
-Are the samples being collected for any purpose other than validation of a laboratory test?
- Will these samples be used for any type of genetic sequencing?
Yes
No
Not sure
Will the results of the specimen analysis be published?
* must provide value
Yes No
Will the results of the specimen analysis be disclosed outside of your laboratory, such as in a presentation in a scientific lecture?
* must provide value
Yes No
Will you maintain records of the specimen analysis to be used in later studies?
* must provide value
Yes No
Are the samples being collected for any purpose other than validation of a laboratory test?
* must provide value
Yes No
Will these samples be used for any type of genetic sequencing?
* must provide value
Yes No
If the answer to any question above is "yes" the study must be reported to Emory’s IRB located here
If you do not have an approved IRB protocol and would like to see an example of IRB language requesting Biorepository samples, please see the attachment below.
Are you employed by Emory?
* must provide value
Yes No
Emory University Principal Investigator name
* must provide value
Emory University department
* must provide value
Anesthesiology Biochemistry Biomedical Engineering Biomedical Informatics Cell Biology Dermatology Emergency Medicine Family & Preventative Medicine Gynecology / Obstetrics Hematology / Medical Oncology Human Genetics Medicine Microbiology / Immunology Neurology Neurosurgery Ophthalmology Orthopedics Otolaryngology Pathology & Laboratory Medicine Pediatrics Pharmacology & Chemical Biology Physiology Psychiatry & Behavioral Sciences Radiation Oncology Radiology & Imaging Sciences Rehabilitation Medicine Surgery Urology
Emory University division
* must provide value
Cardiology Digestive Diseases Endocrinology General Medicine Geriatrics and Gerontology Hospital Medicine Infectious Diseases Pulmonary, Allery, Critical Care, and Sleep Medicine Renal Medicine Rheumatology
Emory University Principal Investigator e-mail
* must provide value
Emory University Principal Investigator phone number
* must provide value
Please provide speedtype for billing purposes
* must provide value
For Billing and Payment processing, the asscoiated speedtype is required for submission. The Georgia CTSA Clinical Research Biorepository Core Laboratory will not bill your account without your knowledge. During the billing period an invoice will be submitted to the Principle Investigator and Study Team for review and approval
RAS/Financial Analyst name
* must provide value
If contact is unknown please enter n/a
RAS/Financial Analyst e-mail
* must provide value
Please note: To facilitate the transfer of biological material between collaborators at different Institutions, a Material Transfer Agreement (MTA) is required and must be attached within this submission.After the Recipient Scientist review and approve the budget provided by the Georgia CTSA Clinical Research Centers Biorepository, the MTA procedures found below will be initiated. Emory University standard MTA agreement for external academia can be found here
MTA Procedures
Step 1: The Recipient Scientist and their Institution will review the budget proposal and MTA. If in agreeance, please e-mail the signed MTA to the GCRC Business Manager at sherrionda.grady@emoryhealthcare.org and gcrc@emory.edu
Step 2: The MTA will be logged for tracking purposes and routed to the appropriate contract office.
Step 3: Emory's OTT department will review and negotiate the terms and conditions of the agreement as needed and obtain all authorized signatures.
Final Step: Transfer of material occurs upon execution of agreement.
Non-Emory Principal Investigator name
* must provide value
Non-Emory Principal Investigator affiliation
* must provide value
CHOA Georgia Tech Morehouse UGA External Academia Industry
If other, please provide affiliation
* must provide value
Non-Emory Principal Investigator e-mail
* must provide value
Non-Emory Principal Investigator phone number
* must provide value
Please list billing details (contact, address, phone, etc.)
* must provide value
Is the preferred contact different from the Principal Investigator?
* must provide value
Yes No
Preferred contact name
* must provide value
Preferred contact e-mail
* must provide value
Preferred contact phone number
* must provide value
Study title
* must provide value
Study description
* must provide value
Please include study purpose, hypothesis and how you intend to use the Biorepository samples
Primary funding source
* must provide value
Investigator-initiated
Industry
NIH
Other federal agency
Foundation
Other
Investigator-initiated
Industry
NIH
Other federal agency
Foundation
Other
If other, please list funding source
* must provide value
Definition of de-identified Biospecimens and/or Data does not contain PHI and must obtain IRB exemption status or expedited approval from the Emory IRB. If you are seeking to obtain de-identifiable specimens, you need to apply for an exemption status from the IRB and include it in your IRB application for reference.
If you need help on your IRB application, please visit: https://www.irb.emory.edu/members/index.html
For additional information regarding office hours, please visit: http://www.irb.emory.edu/about/index.html
For more information regarding IRB guidance for exemption, please see: http://www.irb.emory.edu/index.html
Infectious disease sample(s)
* must provide value
Please select COVID-19 sample type(s)
* must provide value
How many NP Residual COVID-19 samples do you need?
Total Number Positive Samples Negative Samples
Number of requested samples NP Residuals COVID-19
How many of the samples are positive NP Residuals COVID?
How many of the samples are negative NP residuals COVID?
View equation View equation View equation NP Residuals COVID-19 total
View equation How many Bronchoalveolar Lavage (BAL) samples do you need?
Total Samples Positive Samples Negative Samples
Number of requested samples Bronchoalveolar Lavage (BAL)
How many of the samples are positive Bronchoalveolar Lavage (BAL)
How many of the samples are negative Bronchoalveolar Lavage (BAL)
View equation positive Bronchoalveolar Lavage (BAL) cost
View equation Negative Bronchoalveolar Lavage (BAL) cost
View equation Bronchoalveolar Lavage (BAL) total
View equation How many Anterior Nasal samples do you need?
Total Samples Positive Samples Negative Samples
Number of requested samples Anterior Nasal
How many of the samples are Anterior Nasal
How many of the samples are Anterior Nasal covid negative?
View equation positive Anterior Nasal Covid cost
View equation Negative Anterior Nasal Covid cost
View equation Anterior Nasal Covid total
View equation Please select EBOLA Convalescent sample type(s)
* must provide value
Currently we only offer plasma samples. We are currently working on the ability to provide other samples in the near future.
How many Ebola Plasma samples do you need?
Total Number Positive Samples Negative Samples
Number of requested Ebola Plasma Samples
How many of the samples are positive Ebola Plasma Samples
How many of the samples are negative Ebola Plasma Samples
View equation positive Ebola Plasma Samples Cost
View equation Negative Ebola Plasma cost
View equation Negative Ebola Plasma total
View equation Please select FLU sample type(s)
* must provide value
How many Anterior Nasal samples do you need?
Total Number Positive Samples Negative Samples
Number of requested Andterior Nasal Samples
How many of the samples are positive Flu_anterior_nasal Samples
How many of the samples are negative flu_anterior_nasal Samples
View equation positive flu_anterior_nasal Samples Cost
View equation Negative flu_anterior_nasal cost
View equation Negative flu_anterior_nasal total
View equation How many NP Residual Flu samples do you need?
Total Number Positive Samples Negative Samples
Number of requested NP Residual Flu
How many of the samples are positive NP Residual Flu
How many of the samples are negative NP Residual Flu Samples
View equation Negative NP Residual Flu cost
View equation positive NP Residual Flu Samples Cost
View equation Negative NP Residual Flu total
View equation Please select HPV sample type(s)
* must provide value
How to add new sample types 1, If you haven't already, go to 'data exports, reports, and stats' click the 'all data' reports button 'export data' click 'csv/microsoft excel (raw data), and press export data (this saves a copy of the datatbase in case anything goes wrong) Add a sample type in the infectious_disease_sample dropdown or its subsidiaries such as sample_type, or ebola_plasma_samples as needed 2, Then copy: bal_residual_numbers_4 requested_number_hpv_cervical (and all 4 other grey highlighted fields. Drag them to thier separate area (below the correct sample type) give the a unique color give them appropriate variable names make sure the branching and calculated values work See 3 lower on this page!!!!!
How many Cervical/Vaginal samples do you need?
Total Number Positive Samples Negative Samples
Number of requested HPV Cervical/Vaginal samples
How many of the samples are HPV Cervical/Vaginal
How many of the samples are HPV Cervical/Vaginal Samples
View equation Negative HPV Cervical/Vaginal cost
View equation positive HPV Residual Cervical/Vaginal Samples Cost
View equation HPV Residual Cervical/Vaginal total
View equation Please list other infectious disease type(s)
* must provide value
Please list other sample type(s)
* must provide value
How many ______ samples do you need?
Total Number Positive Samples Negative Samples
Number of requested Other Sample Types
Number of requested Positive Sample Types
Number of requested Negative Sample Types
View equation View equation View equation View equation
Protocol
* must provide value
Name of individual submitting this request
* must provide value
3, To add the positive and negative sample requests in the budget, Copy: proposed_budget_14 proposed_budget_15 Drag the coppied version below originals Change the name from 'HPV Cervical/vaginal' to your new sample type Make sure the branching works with the new sample type so it can show in the budget Correct the piping fields to reflec the new sample type go to 4 to complete!!
BIOREPOSITORY SERVICES
Services Quantity Unit Cost Total
Positive NP Residuals COVID-19
______
$______ .00
$______ .00
Negative NP Residuals COVID-19
______
$______ .00
$______ .00
Positive Bronchoalveolar Lavage (BAL)
______
$______ .00
$______ .00
Negative Bronchoalveolar Lavage (BAL)
______
$______ .00
$______ .00
Positive Anterior Nasal COVID-19
______
$______ .00
$______ .00
Negative Anterior Nasal COVID-19
______
$______ .00
$______ .00
Positive Ebola Plasma
______
$______ .00
$______ .00
Negative Ebola Plasma
______
$______ .00
$______ .00
Positive NP Residual Flu
______
$______ .00
$______ .00
Negative NP Residual Flu
______
$______ .00
$______ .00
Positive Anterior Nasal Flu
______
$______ .00
$______ .00
Negative Anterior Nasal Flu
______
$______ .00
$______ .00
Positive HPV Cervical/Vaginal
______
$______ .00
$______ .00
Negative HPV Cervical/Vaginal
______
$______ .00
$______ .00
Positive ______
______
$______ .00
$______ .00
Negative ______
______
$______ .00
$______ .00
*Costs are inclusive of Emory F&A Rate @ 56.5%
*If budget data does not appear, ensure you have answered 'are you employed at Emory' (and your Affiliation if you are not at Emory), your 'Primary funding source', and you have defined the number of samples you need.
BIOREPOSITORY SERVICES
Description of Services Quantity Unit Cost Total Positive ______ $______ .00 $______ .00 Negative ______ $______ .00 $______ .00 Total Budget $______ .00
*Costs are inclusive of Emory F&A Rate @ 56.5%
* You bill was calculated based upon your stated primary funding source: ______
*IMPORTANT: You have chosen 'Other',
- Disease Types: ______
- Sample Types: ______
As we do not have pre-defined prices for these items, this cost will be added to your quote later.
*IMPORTANT: You have chosen 'Ebola Plasma Samples',
As we do not have pre-defined prices for these items, this cost will be added to your quote later.
4, You need to update the nested sum tables to add the new sample to the budget. Update: total_budget requested_number positive_samples negative_samples Calculated Fee______ = '1', '50', if(______ = '2', '50', if(______ = '3', '50', if(______ = '4', '50', if(______ = '5', '50',if(______ = '6', '50','')))))))
View equation
total budget______ != "", ______ , ""), if(______ !="", ______ , ""), if(______ != "", ______ , ""), if(______ !="", ______ , ""), if(______ !="", ______ , ""), if(______ !="", ______ , "") , if(______ !="", ______ , "") , if(______ !="", ______ , "") , if(______ !="", ______ , "") , if(______ !="", ______ , ""))
View equation View equation View equation View equation
Need to calculate these for overall counts
Number of requested samples How many samples are positive? How many samples are negative?
Number of requested samples (this will be a calculate total to keep the backend data consistent with the old system)
View equation How many of the samples are positive? (this will be a calculate total to keep the backend data consistent with the old system)
View equation How many of the samples are negative? (this will be a calculate total to keep the backend data consistent with the old system)______ + ______ + ______ + ______ + ______ + ______
View equation
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