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Required format:

/^((0?[1-9])|([1-8][0-9])|(9[0-8]))[0-9]{3}$/

/^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4}))$/

/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4}))$/

/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31))))$/

/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31)))) (\d|[0-1]\d|[2][0-3]):[0-5]\d$/

/^(?!\.)((?!.*\.{2})[a-zA-Z0-9\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF!#$%&'*+\-/=?^_`{|}~\d]+)(\.[a-zA-Z0-9\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF!#$%&'*+\-/=?^_`{|}~\d]+)*@(?!\.)([a-zA-Z0-9\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF\-\.\d]+)((\.([a-zA-Z\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF]){2,63})+)$/i

/^[-+]?\b\d+\b$/

/^[a-z]+$/i

/^\d{10}$/

/^[a-z0-9-_]+$/i

/^[-+]?[0-9]*\.?[0-9]+([eE][-+]?[0-9]+)?$/

/^-?\d+,\d$/

/^-?\d+\.\d$/

/^-?\d+,\d{2}$/

/^-?\d+\.\d{2}$/

/^-?\d+,\d{3}$/

/^-?\d+\.\d{3}$/

/^-?\d+,\d{4}$/

/^-?\d+\.\d{4}$/

/^[-+]?[0-9]*,?[0-9]+([eE][-+]?[0-9]+)?$/

/^($0[2-8]$|0[2-8])\s*\d{4}\s*\d{4}$/

/^(?:$?([2-9]0[1-9]|[2-9]1[02-9]|[2-9][2-9][0-9]|800|811)$?)\s*(?:[.-]\s*)?([2-9]1[02-9]|[2-9][02-9]1|[2-9][02-9]{2})\s*(?:[.-]\s*)?([0-9]{4})(?:\s*(?:#|x\.?|ext\.?|extension)\s*(\d+))?$/

/^\d{4}$/

/^[ABCEGHJKLMNPRSTVXY]{1}\d{1}[A-Z]{1}\s*\d{1}[A-Z]{1}\d{1}$/i

/^(0[1-9]|[1-9]\d)\d{3}$/

/^\d{3}-\d\d-\d{4}$/

/^([0-9]|[0-1][0-9]|[2][0-3]):([0-5][0-9])$/

/^[0-5]\d:[0-5]\d$/

/^[0-9]{4,9}$/

/^\d{5}(-\d{4})?$/

fCxVqrgHB6hxbpcsfxtZBPEP3XcYpM6VF4oKJkitL9Lv8cwUViCkbnvX5Xpv4A2r4qcfNCBwxbUM7F8KFb2JIezxx7qkQXJ

PNRR Kit Request System

Study Site

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Johns Hopkins University

Remi Ben-Davies
600 N. Wolfe Street
Meyer Bldg 5-119
Baltimore, MD 21287

Phone: 410-614-4188
rbendav1@jhmi.edu

Mount Sinai School of Medicine

Daphne Edgren
1 Gustave Levey Place
Annenberg Building, Room 2-40
New York, NY 10029-6500

Phone: 212-241-4251
Fax: 212-987-3301
daphne.edgren@mssm.edu

Beth Israel Deaconess Medical Center

Michael McCormick

Center for Autonomic and Peripheral Nerve Disorders
Beth Israel Deaconess Medical Center
185 Pilgrim Road, Palmer 111
Boston, MA 02215

Phone: 617-632-8454
mpmccorm@bidmc.harvard.edu

Northwestern University

Benjamin Joslin, Emma Schmidt
Northwestern FPN CCC
259 East Erie Street, 19th floor
Lavin Pavilion
Chicago, IL 60611-5970

Phone: (312) 503-7504
ben.joslin@northwestern.edu
emma.schmidt@northwestern.edu

University of Utah

Wesley Borden
Department of Neurology
University of Utah, Clinical Neuroscience Center
175 N Medical Drive, Room 3335
Salt Lake City, UT 84132

Phone: 801-585-2772
Email: Wesley.borden@hsc.utah.edu

University of Kansas Medical Center

Melissa Hayes
University of Kansas Medical Center
Department of Neurology
4330 Shawnee Mission Parkway, Suite 3340
Fairway, KS 66205

Phone: 913-588-0684
Email: mcurrence@kumc.edu

Washington University in St. Louis

Hetty Bai
Washington University in St. Louis Neurology
4523 Clayton Ave St. Louis, MO 63110
ATTN: 105 Biotechnology Center Geisler

Cellphone Number: 240-308-0013
Lab Phone: 314-273-3087
Email: baih@wustl.edu

University of Michigan

Amro Stino, MD
University of Michigan Health System
ATTN: Amro Stino, MD
Department of Neurology, UH South F2647
1500 E. Medical Center Drive
Ann Arbor, MI 48109-5246

For Shipping Questions: 734-936-8586
Fax: 734-936-5185
Email: amstino@med.umich.edu

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New Shipping Address

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Is the e-mail address above correct?

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Yes

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New E-mail Address

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Kit Type

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Site/Individual Label Set

Ambient Blood (DNA Only) Kit

Serum/Plasma/DNA Kit

Dry Ice Shipper Kit

Extra Supplies

REDRAW Saliva Kit

Requested Participant IDs

DNA Only Kit Quantity

Serum/Plasma/DNA Kit Quantity

*Due to ongoing supply issues, the PNRR kits will contain either 2 x 10mL EDTA tubes OR 3 x 6mL EDTA tubes for plasma collection, depending on availability. We will inform you which size EDTA tubes are included in the kits at time of shipment.

Small Dry Ice Shipper Quantity

Large Dry Ice Shipper Quantity

10mL EDTA tubes (plastic)

*Due to ongoing supply chain issues, 6mL EDTA tubes could be used to replace 10mL EDTA tubes for plasma collection, depending on availability.

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6mL EDTA tubes

*Temporary replacement for 10mL EDTA tubes

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5mL SST tubes

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2mL purple-capped cryovials (plasma)

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2mL yellow-capped cryovials (serum)

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2mL clear-capped cryovials (buffy coat)

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Disposable pipettes (1mL)

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Small Biohazard bags w/ absorb. sheet

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Ambient shipping supplies for DNA Only kits (canister, box, UPS ClinPak and label)

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Shipping label packet (1 white Dry Ice label, 1 Fragile Label, 1 UN3373 label, and 1 clear UPS airbill sleeve)

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Date Needed

M-D-Y

Comments

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Each DNA Only Kit Includes:

1 6mL EDTA tube
1 Ambient Shipper Kit
1 Sample Form
1 UPS ClinPak

Each Serum/Plasma/DNA Kit Includes:

2 10mL EDTA tubes (or 3 6mL EDTA tubes, depending on availability due to ongoing supply chain issues)
2 5mL SST tubes
10 purple-capped 2mL cryovials
5 yellow-capped 2mL cryovials
2 clear-capped 2mL cryovials
1 15mL conical tube
4 disposable pipettes (1mL)
1 25-slot cryobox
1 small biohazard bag w/ absorb. sheet
1 Sample Form

Each Small Dry Ice Shipper Includes:
1 insulated shipper (11 x 9 x 15")
1 white dry ice label
1 clear UPS airbill sleeve
Assorted box labels

Each Large Dry Ice Shipper Includes:
1 insulated shipper (16 x 16 x 16")
1 white dry ice label
1 clear UPS airbill sleeve
Assorted box labels

Each REDRAW Saliva Kit Includes:

1 DNA Saliva Kit
1 Saliva Kit Biohazard Bag
1 10 x 13 Envelope
2 Small Bubble Mailers
1 IU UPS Return Air Waybill
1 Sample Form

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