Registration for Pheno Typing Symposium

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JHU Phenotyping Core

GEM TEST REQUEST SITE

Please provide information as specifically and completely as possible.

Investigator Name:«

Email:

Submitter:«

Contact # &/or Email:«

To schedule/coordinate testing

Charge Number:

REQUIRED when tests are requested.

Mouse Facility & Room #:«

Animal ID:

What you/your group call these mice.

Full name/designation if known

(http://www.informatics.jax.org/mgihome/nomen/strains.shtml)

Control mice:«

Names and sources of relevant control mice to be tested at the same time

Are these MGI or IMSR registered names?

(http://dels.nas.edu/ilar_n/ilarhome/register_lc.php)

[ Yes ] [ No ]

Background Strains

(include substrains, N and F generations if known)

Mutation(s)

(Use current Gene/Locus names please, per MGI)

Is the mouse/mutation information in the JHMI GEM Database? (no charge)

http://www.hopkinsmedicine.org/JHUphenotyping/JHMIGEM/home.html

[ Yes ] [ No ]

Number, sexes, and genotypes of mice to be tested:

Age(s), or Date(s) of Birth:

Source of Mice:«

Where were the mice born?

Coat Color(s):

Are the mice known or expected to be:

Blind	Deaf
Immune Deficient	No Idea

HISTORY & known or expected phenotypes:

(Include any manipulations, bleeding, testing, special diets, treatments, unusual observations)

Cagemates:

This information can be especially relevant to behavioral phenotypes.

None	Same Sex
Littermates	Breeding

# Female Cagemates:

# Male Cagemates:

Caging:

Diet:

Water:

Tests Requested:

Other Tests:

Contact Phenocore@jhmi.edu regarding special requests

Fields marked with "«" are required.

Follow this link for pricing and additional test information (in a new window).