Imaging Facility Training Requisition Form

Imaging Facility Training Requisition Form
To proceed with training, please complete this form so that your imaging experience and experimental needs can be assessed. Once returned, the imaging specialist will contact you to book a consultation. Fill out a new form for each new experimental aim.
Trainee/Staff Information
Name*

First NameLast Name
Position*
Email*
example@example.com
Lab*
Are you a research visitor or student that will be working here for 6 months or less?

YesNo

Previous Training and Experience
Identify all imaging systems which you have been previously trained to use. (Check all that apply.)

Basic training - Olympus BX50Zeiss Wide Field with DeconvolutionZeiss Live Cell with FLIMQuorum Spinning DiscQuorum Spinning Disc with TIRFNikon A1R with MultiphotonBiotek Cytation 5Zeiss Cell Discoverer 7Other
List the imaging systems you have experince with.*

Sample Type
Select your sample type.*

Cell MonolayerTissueOrganoid or OrganismOther
Tissue Thickness (in um)*
Tissue Preparation*

FFPECryo-section
Describe your sample including dimensions and thickness (in um).*
Describe the type of organoid or organism and its dimensions including thickness (in um). *

Safety
Does your sample contain any hazardous material (biological and/or chemical)?*

YesNo
Indicate the risk group of your sample/pathogen.*

RG1RG2
Indicate if the pathogen is in your lab’s biosafety permit.*

YesNo
Describe hazardous materials (biological and/or chemical).*
Any samples (cells, tissues, organisms etc.) brought into the imaging facilities should follow all biosafety and vivarium safety protocols. Any chemical hazards should follow appropriate containment and disposal protocols. All surfaces in contact with cells, tissues, or animals should be cleaned and dried. Gloves from your lab should not be brought into imaging facilities although you may put on clean ones.*

Acknowledged

Fluorescence Requirements
Indicate all fluorophores and/or fluorescent proteins in your sample.*

UV excitable - Alexa 405, DAPI, Hoechst 33258, etc.Violet excitable - Alexa 430, eCFP, Lucifer Yellow, etc.Blue excitatiable - Alexa 488, eGFP, Fluo4, FITC, etc.Cyan excitatiable - Alexa 514, eYFP, Eosin, TOTO-1 etc.Green excitatable - Alexa 555, Cy3, TRITC, DsRed, etc.Yellow excitatable - Alex 568, Alexa 594, mCherry, mPlum, etc.Red excitable - Alexa 631, Alexa 647, Cy5, TOTO-3, etc.Other
Provide excitation and emission characteristics. (These can be found with online spectral viewers or on product information pages.)*

Transmitted Light Requirements
Indicate transmitted light requirements*

Bright fieldColour bright field (e.g. for H&E)Phase ContrastDICNone

Resolution Requirements
What is the required spatial resolution?*

200nm -500nm (e.g. centrosomes)500nm - 1um (e.g. small organelles)1um - 5um (e.g. large organelles, platelets etc.)5um -20um (e.g. nuclei)> 20um (e.g. cells)Unsure

Acknowledgements
Completion of online training modules as well as basic training in wide-field microscopy is a prerequisite for advanced training.*

Acknowledged
The imaging facility is not responsible for lost data. It is the user's responsibility to back up raw data and record all processing and analysis steps.*

Acknowledged
Misuse of imaging facility systems may result in loss of access and/or fees for cleaning and repair of damaged equipment as necessary.*

Acknowledged
If the Core Specialists have provided substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work, please include them in the authorship list.*

Acknowledged
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To proceed with training, please complete this form so that your imaging experience and experimental needs can be assessed. Once returned, the imaging specialist will contact you to book a consultation. Fill out a new form for each new experimental aim.