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My CMS
Lynn Bry MD, PhD, Director
Georg Gerber MD, PhD, MPH, Co-Director
Neil Herring, MBA, Corporate Manager
Andrew Onderdonk, PhD
Service Request Form
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A: Principal Investigator Information
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First
Last
Phone Number:
Email
*
Primary Contact
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First
Last
Phone Number:
Email
*
Address:
Institutional Affiliation:
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Affiliation:
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Internal, Partners Healthcare
Harvard Digestive Diseases Center
External Academic, Non-profit Institution
Commercial, Industry
Harvard Digestive Diseases Member:
Yes
No
Do not know
Funding Source:
Supporting Grant Number
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Provide grant number(s) for any research to be supported by requested MHMC services. Type N/A if not applicable.
Services requested: please check all that apply:
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Microbiology
Molecular
Gnotobiotics
Computational
CLIA Testing
Functional Metabolism
Prior to the start of a project the investigator must provide: a copy of IACUC or IRB protocol, protocol approval letter and Peoplesoft# or PO#.
Scientific question(s) or requested services:
*
Website
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