UNMC

Embryo Cryopreservation Submission Form

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C.B. Gurumurthy, Ph.D.
Mouse Genome Engineering Core Director
402-559-3338
Email

All fields are required.

Lab Information

Principal Investigator: 
Department/Institution: 
Email:
Contact Person:
E-mail:
Phone:
Person/Dept Billing should be directed:
Cost/Center Number:
IACUC approval number and title to Transfer Animals from:
Mouse Line to be Cryopreserved:
Strain of Mice to be Cryopreserved: C57B1/6 FVB 129 CD-1 Other
Genotype: Homozygote Heterozygote
Can MGECF freeze this line as heterozygous? Yes No
Number of Stud Males: Age: Months or weeks?
If Mice must be maintained only as Homozygous: Number Females Age:
Present location of animals: Building: Room Number:
Provide Health Status REPORT
What is known about the reproductive status of these mice?
Average age if first litter: Average litter size:
How many litters are expected from each female?

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Form last updated 03/26/18

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