Application for Tissue from the Alabama Brain Collection

To request tissue from the Alabama Brain Collection please provide answers to the following questions. Email this form back as an attachment to Dr. Rosalinda C. Roberts Ph.D. at This email address is being protected from spambots. You need JavaScript enabled to view it.

1.    State the title of your project:

 2.   Principal Investigator:

           Telephone number:

           Email address:

           Institutional affiliation:

           Mailing address:

 3.  Briefly describe the rationale of the study, the hypotheses that will be tested, and the goals for the study.

 4.  Briefly describe preliminary studies and assurance that the techniques you propose to use will work in postmortem human tissue.

 5.  Indicate the requested clinical characteristics (e.g., DSM-IV diagnoses, medication sub-grouping, etc.).

 6.   State the requested demographics (gender, age, race, PMI, drug history, etc.).

 7.  Identify the funding source for the project or the projected funding source if tissue is needed for a pilot study.

 8.   Add/Describe:

       a.     Diagram of the brain region(s) to be studied (you may attach a jpeg, gif, or tiff image file)

       b.    How much tissue is needed (size of block, sections, etc.);

       c.     Method of tissue preservation (fixed/frozen, etc.);

      d.    Investigative techniques to be used.

 Send your request to the Dr. Rosalinda C. Roberts.  Your request will be presented to the Alabama Brain Collection Steering Committee.  You will be notified about the decision of the ABC Steering Committee in a timely fashion.  The investigator is responsible for tissue processing and courier charges. When your tissue request is approved, you will need to submit a signed Collaboration Agreement which also is available online.