Please enter your email address here to receive a confirmation email after completing the survey:
* must provide value
Today M-D-Y
3 Weeks from now:
* must provide value
View equation
LEADS Site
* must provide value
Columbia University Harvard University, Massachusetts General Hospital Johns Hopkins University Mayo Clinic Jacksonville Mayo Clinic Rochester Northwestern University University of California Los Angeles University of Pennsylvania Washington University, St. Louis University of California, San Francisco Emory University Houston Methodist University of Wisconsin, Madison Indiana University Butler Hospital Banner Sun Health Research Institute Georgetown University Wien Center/MSMF Stanford University University of California, San Diego TEST SITE
010: Columbia University
ATTN: Arlene Mejia
Columbia University
622 West 168th, PH19-406
New York, NY 10032
Phone: (212) 305-9168
Fax: (212) 305-2526
Email: AM4717@CUMC.COLUMBIA.EDU
011: Washington University, St. Louis
ATTN: Heather Klemp
Washington University, St. Louis
4488 Forest Park
Suite 101 - Campus Box 8111
St. Louis, MO 63108
Phone:
email: hklemp@wustl.edu
036: Mayo Clinic, Jacksonville
BAPJA-SAS
Attn: Kits
4500 San Pablo Rd.
CS 150, Jacksonville, FL 32224
Phone:
thomas.anton@mayo.edu
Thomas Anton
360: Harvard University, Massachusetts General Hospital
ATTN: Sam Murdock
Massachusetts General Hospital
149 13th Street #10081J
Charlestown, MA 02129
Phone: 617-643-5568
Email: smurdock2@mgh.harvard.edu
007: Mayo Clinic, Rochester
ATTN: Emily Berg
Mayo Clinic Alzheimer's Disease Research Center
Center 41st Street Professional Building
3033 41st Street NW
Rochester, MN 55901
Phone: 507-293-5669
Email: berg.emily@mayo.edu
018: Johns Hopkins University
ATTN: Akshata Balaji / Ann Fishman
JHU School of Medicine
550 N Broadway
Rm 953
Baltimore, MD 21205
Phone: 410-550-6486
Email: abalaji4@jhu.edu
099: Banner Sun Health Research Institute
ATTN: Kelly Clark
Banner Sun Health Research Institute
10515 W. Santa Fe Dr.
Sun City, AZ 85351
Phone: (623) 832-6527
Fax: (623) 832 1750
Email: Kelly.Clark2@bannerhealth.com
067: Northwestern University
Cognitive Neurology and Alzheimer's Disease Center (CNADC)
Northwestern University
Feinberg School of Medicine
Caila Ryan
300 East Superior Street, Tarry 8th floor
Chicago, IL 60611
Phone: 312-503-5674
caila.ryan@northwestern.edu
035: University of California, Los Angeles
ATTN: Diana Chavez
UCLA
11301 Wilshire Blvd.
Mail Code 116AF (Bldg 206, Room 108)
Los Angeles, CA 90073
Phone: 562-668-1875
Email: dianachavez@mednet.ucla.edu
022: University of Pennsylvania
ATTN: Laura Schankel
Penn Memory Center, 3400 Civic Center Blvd
2nd Floor South Pavilion
Philadelphia, PA 19104
Phone: 215.519.7709
Email: Elizabeth.Robinson@Pennmedicine.upenn.edu
073: University of California, San Francisco
ATTN: Ranjani Shankar, Clinical Research Coordinator
UCSF Memory & Aging Center
675 Nelson Rising Lane, Suite 190 MB: 1207
San Francisco, CA 94158
Email: ranjani.shankar@ucsf.edu
Phone: 415-502-7155
032: Emory University
Antanique Darling
6 Executive Park Drive NE
2nd floor
Atlanta, GA 30329
Phone: 404-712-6914/404-712-6867
Email: adarli2@emory.edu
037: IU
ATTN: Sarah Hutchens
IU Department of Neurology
355 W. 16th St., Room 4700
Indianapolis, IN 46202
Phone: (317) 274-9249
Email: saradavi@iu.edu
127: University of Wisconsin
ATTN: Christina Chin
University of Wisconsin-Madison
600 Highland Avenue, K6/4
MC4670
Madison, WI 53792-4670
Phone:
Email: cechin@wisc.edu
177: Houston Methodist
ATTN: Carlos Zarate
Houston Methodist
6560 Fannin, Ste 750
Houston, TX 77030
Phone: 713-441-9484
Email: czarate@houstonmethodist.org
941: Butler Hospital
ATTN: Priscilla Villa
Butler Hospital, Memory and Aging Program
345 Blackstone Blvd
Providence, RI 02906
Email: pvilla@carene.org
Phone: 401-455-6403
082: Georgetown University
ATTN: Jessica Mallory
4000 Reservoir Rd., NW
Building D, Suite 177
Washington DC 20057
Email: jp1715@georgetown.edu
Phone: 202-687-3355
005: University of California, San Diego
UC San Diego Shiley-Marcos Alzheimer's Disease Research Center
ATTN: Christopher Slowik
9444 Medical Center Dr. Ste. 1-100
MC: 0948
La Jolla, CA 92037
Phone: 858-822-4800
Email: cslowik@ucsd.edu
016: Wien Center/MSMC
ATTN: Joanna Gonzalez
Mount Sinai Medical Center (MSMC)
Wien Center
4302 Alton Road, Suite 650
Miami Beach, FL 33140
Email: Joanna.Gonzalez@msmc.com
Phone:
098: Stanford University
ATTN: Stephanie Tran
Stanford Neuroscience Health Center
213 Quarry Road, MC 5978
Palo Alto, CA 94304-5978
Email: trans@stanford.edu
Phone: (650) 521-7287
123: Test Site
ATTN: Site Coordinator Contact
Indiana University
Indianapolis, IN 46202
Phone: 317-123-1234
test@iu.edu
Is the contact name above correct?
* must provide value
Yes
No
New Contact Name
* must provide value
Is the e-mail address above correct?
* must provide value
Yes
No
New E-mail Address
* must provide value
Is the shipping address for kit delivery above correct?
* must provide value
Yes
No
New Shipping Address
* must provide value
Where will the samples delivered to NCRAD be shipping from?
* must provide value
Same as shipping address for kit delivery
Different address
CI Baseline Blood-Based Kit Qty
CI M12, M24, M36, M48 Blood-Based Kit Qty
CI M12 CI M24 CI M36 CI M48
CI M12 Blood-Based Kit Qty
CI M24 Blood-Based Kit Qty
CI M36 Blood-Based Kit Qty
CI M48 Blood-Based Kit Qty
CI M60 Blood-Based Kit Qty
CN Baseline Blood-Based Kit Qty
CN M12 Blood-Based Kit Qty
CN M24 Blood-Based Kit Qty
Long Read Sequencing Blood-Based Kit Qty
LEADS Blood Supplemental Supply Kit Qty (usually need 1 at start-up)
LEADS Large Frozen Blood Shipping Supply Kit Qty (will fit samples from 5 subjects)
LEADS Small Frozen Blood Shipping Supply Kit Qty (will fit samples from 2 subjects)
LEADS Ambient Shipping Supply Kit Qty (need 1 per subject)
LEADS CSF Kit Qty (please provide arm and visit for each CSF kit in the "Comments" section)
LEADS CSF Supplemental Supply Kit Qty (usually need 1 at start-up)
LEADS CSF Shipping Supply Kit Qty (only needed when planning on shipping CSF separate from blood - rarely needed)
Picture of 25 slot cryobox
Picture of 81 slot cryobox
Picture of 2mL Lavender Cryovial (CV027)
Picture of 2mL Red Cryovial (CV028)
Picture of 2mL Orange Cryovial (CV017 & CV018)
Picture of 2mL Clear-Cap Cryovial (CV014)
picture of 2mL Blue Cryovial (CV034)
Picture of UPS Laboratory Paks (SH053)
Image of UPS Dry Ice label
Picture of Aqui-Pak 6 tube absorbent pouch (SH011)
Picture of Small refrigerant pack (3 oz) (SH038)
Picture of Disposable graduated transfer pipette (CV015)
Picture of PAXgene™ Blood Collection Tube (2.5 ml) (CT004)
Picture of Plain Red Top Serum (Red-Top) Blood Collection Tube (10 ml) (CT006)
Picture of 10mL NaHep Green-Top Blood Collection tube
Picture of 10mL EDTA Lavender-Top Blood Collection Tube
Picture of 6mL EDTA Lavender-Top Blood Collection Tube
"Our standard shipping time for all orders is 2-3 weeks. If you need any items from this order expedited, please indicate the earliest date you will need these supplies and write which items need expedited in the comment section."
Today M-D-Y
Our standard shipping time for all orders is 3 weeks.
We can ship this kit request by: ______
If you need any supplies in this order prior to ______ , you must contact the NCRAD coordinator for this study: agericks@iu.edu.
Each CI (EOAD) Baseline Blood-Based Kit Contains:
IU site: Finale KIT312 All other sites: Finale 154.2.2
1 PAXgene™ Blood Collection Tube (2.5 ml) - CT004 1 Plain Red Top Serum (Red-Top) Blood Collection Tube (10 ml) - CT006 2 Sodium Heparin (Green-Top) Blood Collection Tube (10 ml) - CT008 3 EDTA (Lavender-Top) Blood Collection Tube (10 ml) - CT001 1 EDTA (Lavender-Top) Blood Collection Tube (6 ml) - CT003 9 Cryovial tube (2.0 ml) with LAVENDAR cap - CV027 3 Cryovial tube (2.0 ml) with RED cap - CV028 2 Cryovial tube (2.0 ml) with BLUE cap - CV034 3 Cryovial tube (2.0 ml) with CLEAR cap - CV014 4 Disposable graduated transfer pipette (3 ml) - CV015 1 50ml conical (Unwrapped) - CV019 8 Bubble wrap tube sleeve - SH032 (Note to sites: Reuse 3 for frozen blood tubes for shipping) 1 81-cell cryobox - CV021 1 Resealable bag - ST002 Labels : 25 Pre-printed Collection and Aliquot Tube Label (13 x PLASMA, 5 x SERUM, 2 x PBMC, 1 x RNA, 3 x BUFFY COAT, & 1 X WBLD) - LB003 4 Pre-printed Kit Number Label - LB003 10 Labels for handwritten Site and LEADS ID - LB003 Each CI (EOAD) M12, M24, M36, M48, M60 Blood-Based Kit contains:
IU site: Finale 10682 All other sites: Finale 155.2
1 PAXgene™ Blood Collection Tube (2.5 ml) - CT004 1 Plain Red Top Serum (Red-Top) Blood Collection Tube (10 ml) - CT006 2 Sodium Heparin (Green-Top) Blood Collection Tube (10 ml) - CT008 3 EDTA (Lavender-Top) Blood Collection Tube (10 ml) - CT001 9 Cryovial tube (2.0 ml) with lavender cap - CV027 3 Cryovial tube (2.0 ml) with red cap - CV028 2 Cryovial tube (2.0 ml) with blue cap - CV034 3 Cryovial tube (2.0 ml) with clear cap - CV014 4 Disposable graduated transfer pipette (3ml) - CV015 1 50ml conical - CV019 7 Bubble wrap tube sleeve - SH032 (Note to sites: Reuse 2 for frozen blood tubes for shipping) 1 81-cell cryobox - CV021 1 Resealable bag - ST002 Labels : 24 Pre-printed Collection and Aliquot Tube Label (13 x PLASMA, 5 x SERUM, 2 x PBMC, 1 x RNA, & 3 x BUFFY COAT) - LB003 4 Pre-printed Kit Number Label - LB003 9 Labels for handwritten Site and LEADS ID - LB003 Each CN Baseline, M12, M24 Blood-Based Kit Contains:
IU site: Finale KIT314 All other sites: Finale 156.2.2
1 PAXgene™ Blood Collection Tube (2.5 ml) - CT004 1 Plain Red Top Serum (Red-Top) Blood Collection Tube (10 ml) - CT006 2 Sodium Heparin (Green-Top) Blood Collection Tube (10 ml) - CT008 3 EDTA (Lavender-Top) Blood Collection Tube (10 ml) - CT001 9 Cryovial tube (2.0 ml) with lavender cap - CV027 3 Cryovial tube (2.0 ml) with red cap - CV028 2 Cryovial tube (2.0 ml) with blue cap - CV034 3 Cryovial tube (2.0 ml) with clear cap - CV014 4 Disposable graduated transfer pipette (3ml) - CV015 1 50ml conical - CV019 7 Bubble wrap tube sleeve - SH032 (Note to sites: Reuse 2 for frozen blood tubes for shipping) 1 81-cell cryobox - CV021 1 Resealable bag - ST002 Labels : 25 Pre-printed Collection and Aliquot Tube Label (13 x PLASMA, 5 x SERUM, 2 x PBMC, 1 x RNA, & 3 x BUFFY COAT) - LB003 4 Pre-printed Kit Number Label - LB003 9 Labels for handwritten Site and LEADS ID - LB003 Each Long Read Sequencing Blood-Based Kit (10844) Contains:
1 Resealable Bag - ST002 1 EDTA (Lavender-Top) Blood Collection Tube (3 ml) - CT021 3 Cryovial tube (2.0 ml) with green cap - CV064 1 Cryovial tube (2.0 ml) with blue cap - CV034 1 Disposable graduated transfer pipette (3ml) - CV015 Labels : 5 Pre-printed Collection and Aliquot Tube Label - LB003 2 Pre-printed Kit Number Label - LB003 1 Labels for handwritten Site and LEADS ID - LB003 Each Blood-Based Supplemental Supply Kit (157.1.1) Contains:
5 PAXgene™ Blood Collection Tube (2.5 ml) - CT004 5 Plain Red Top Serum (Red-Top) Blood Collection Tube (10 ml) - CT006 10 Sodium Heparin (Green-Top) Blood Collection Tube (10 ml) - CT008 10 EDTA (Lavender-Top) Blood Collection Tube (10 ml) - CT001 5 EDTA (Lavender-Top) Blood Collection Tube (6 ml) - CT003 20 Cryovial tube (2.0 ml) with lavender cap - CV027 10 Cryovial tube (2.0 ml) with red cap - CV028 5 Cryovial tube (2.0 ml) with blue cap - CV034 5 Cryovial tube (2.0 ml) with clear cap - CV014 5 50ml conical (WRAPPED) - CV056 20 Disposable graduated transfer pipette (3ml) - CV015 10 Bubble wrap tube sleeves for frozen blood tubes - SH032 5 81-cell cryobox - CV021 Labels 10 Labels for handwritten Site and LEADS ID - LB003 Each LEADS Large Frozen Blood Shipping Supply Kit (Kit10614.1) Contains: 5 Plastic Biohazard bag (Large) - SH025 5 Absorbent Sheets (250mL) - SH028 1 Resealable bag - ST002 1 Shipping box/Styrofoam container - Large (External 17x17x17") - SH003 1 Shipping Pouch - SH058 1 Dry Ice label - LB016 1 UN3373 label - LB008 1 Fragile label - SH048
*A Large Frozen Blood Shipping Supply Kit will fit samples from 5 subjects
Each LEADS Small Frozen Blood Shipping Supply Kit (10648) Contains: 2 Plastic Biohazard bag (Large) - SH025 2 Absorbent Sheets (250mL) - SH028 1 Resealable bag - ST002 1 Shipping box/Styrofoam container - Small (External 11x9x15") - SH005 1 Shipping Pouch - SH058 1 Dry Ice label - LB016 1 UN3373 label - LB008 1 Fragile label - SH048
*A Small Frozen Blood Shipping Supply Kit will fit samples from 2 subjects
Each LEADS Ambient Blood Shipping Supply Kit Contains:
1 UPS Clinic Pak - SH053
1 Shipping Pouch - SH058
Ambient Mailer Kit - SH008: 1 Plastic biohazard bag 1 Aqui-Pak 6 tube absorbent pouch 1 Small IATA shipping box with insulated cooler 1 Small refrigerant pack (3 oz) 1 UN3373 Biological Substance Category B label 1 List of contents card
Each LEADS 22G LP Kit (LP005) Contains: 1 Sprotte needle, 22 gauge X 3.5" (90mm) 1 Introducer needle, 1 mm x 30 mm 1 Hypodermic needle, 22 gauge x 1.5" 1 Plastic syringe, (3 ml, luer lock) with 25G x 5/8" needle attached 4 Polypropylene syringe (5 ml, Luer lock) 1 Needle stick pad 1 Adhesive bandage 1 Drape, fenestrated, 2 tabs, paper, 18" x 26" 2 Towel, 13.5" x 18" 6 Gauze pad, 2" x 2" 3 Sponge stick applicator 2 Lidocaine 1%, 5 ml 1 Povidone-Iodine Topical Solution, 0.75 oz
Each LEADS 24G LP Kit (LP002) Contains: 1 Sprotte needle, 24 gauge X 3.5" (90mm) 1 Introducer needle, 1 mm x 30 mm 1 Hypodermic needle, 22 gauge x 1.5" 1 Plastic syringe, (3 ml, luer lock) with 25G x 5/8" needle attached 4 Polypropylene syringe (5 ml, Luer lock) 1 Needle stick pad 1 Adhesive bandage 1 Drape, fenestrated, 2 tabs, paper, 18" x 26" 2 Towel, 13.5" x 18" 6 Gauze pad, 2" x 2" 3 Sponge stick applicator 2 Lidocaine 1%, 5 ml 1 Povidone-Iodine Topical Solution, 0.75 oz
Each LEADS CSF Kit Contains:
IU site: Finale KIT311 All other sites: Finale 160.1.1
13 Cryovial tube (2.0 ml) with orange cap - CV017 + CV018 1 Cryovial tube (2.0 ml) with yellow cap - CV037 1 Cryovial tube (2.0 ml) with blue cap - CV034 3 Individually packed Sterile 15 ml Conical Tube - CV029 1 Individually packed Sterile 50 ml Conical Tube - 1 Resealable bag - ST002 1 25 slot cryobox - CV005 Labels : 14 Pre-printed CSF collection and Aliquot Tube Label - LB003 3 Pre-printed Kit Number label - LB003 3 Labels for handwritten Site and LEADS ID - LB003 Each CSF Supplemental Supply Kit (10663) Contains: 10 (50-ml) conical polypropylene tube-individually wrapped - CV056 20 (15-ml) conical polypropylene tube-individually wrapped - CV029 20 Cryovial tube (2.0 ml) with orange cap - CV017 + CV018 5 Cryovial tube (2.0 ml) with yellow cap - CV037 5 Cryovial tube (2.0 ml) with blue cap - CV034 4 Styrofoam Shipping Containers (Small frozen shipper/Sm brain box) (8x6x12 internal, 11x9x15 external) - SH005 3 Shipping Pouches - SH058 3 Dry Ice Shipping Label - LB005 3 UN3373 Label - LB008 3 Fragile Label - SH048 3 Biohazard Label - LB009 10 Small biohazard bags with absorbent sheets - SH015 5 (3 ½" X 22G) Sprotte needle with Introducer (90mm) - LP006 10 Adhesive Spot Bandage - BP040 100 Alcohol Prep Pad - BP037 3 Resealable bag - ST002
Each CSF Shipping Supply Kit (Kit10617) Contains: 1 Styrofoam Shipping Containers (Small frozen shipper/Sm brain box) (External 10x12x16") - SH005 1 Small biohazard bag with absorbent sheet - SH015 1 Shipping Pouch - SH058 1 Dry Ice Shipping Label - LB005 1 UN3373 Label - LB008 1 Biohazard Label - LB009 1 Fragile Label - SH048 1 Resealable Plastic Bag - ST002
Kit Accommodations
Site 037:
SEPERATE BLOOD & CSF kits
Do not include pipettes
Do not include conicals for BLOOD kits
No shipping required
**ONLY use 25-cell cryoboxes**