FACS ACCESS

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To Current FACS Core users: Please do not use this form to update your PTAO

If you already have a valid FACS Access/Calendars for the Web account and you only need to update your PTAO and expiration date, then follow the directions at the bottom of our instructions webpage to access your CW account page where you can update those fields.

If you need to change other account information (eg PI, account admin, etc) or if you do not have a valide FACS Access/Calendars for the Web account then please proceed and complete the form below.

Request For Flow Cytometry Core Access

The following information must be provided before you may schedule time in the Flow Cytometry Core. The billing information will be used to charge for approved usage of the facility. The investigator is responsible for maintaining this information in an accurate and timely manner. If the PTAO number provided expires and a requested replacement is not received then the Department's suspense account will be used until a replacement is provided. Completion of this form assumes approval by the Principal Investigator for use of the facility and all associated charges.

The Center Shared Resource Information will be used to report the use of this facility to the NIH. Current Center members must complete this information to receive their co-pay.

PI Last Name*

PI First Name*

Department*

Box Number*

PI e-mail*

PI phone number*

Researcher (User) Last Name*

Researcher (User) First Name*

Researcher (User) Phone Number*

Researcher (User) Fax Number

Researcher (User) e-mail*

Account Administrator Last Name*

Account Administrator First Name*

Account Administrator e-mail*

Account Administrator Phone Number*

Account Administrator Fax Number

Account Administrator PO Box*

PTAO number for charges (must contain 21 digits)*

Funding Expiration Date (mm/dd/yyyy)*

The following questions only apply to researchers who are eligible for co-payment of their fees via their department or other sources. Enter 'NA' in the following text boxes if you are not eligible for a co-pay:

This project is eligible for a co-pay from the: (choose one)*

Digestive Health Center None

Title of Eligible Project (Enter "NA" if not eligible for co-pay)*

Funding Source (Enter "NA" if not eligible for co-pay)*

Grant Number (Enter "NA" if not eligible for co-pay*

University of Virginia Health System

To Current FACS Core users: Please do not use this form to update your PTAO

Request For Flow Cytometry Core Access