Sample Collection Kits and Supplies

Complete the form below to order sample collection kits for Hoosier Cancer Research Network studies.

If you have any questions about ordering kits, please contact the biorepository team at biorepository@hoosiercancer.org.

Name*
First Last
Institution*
Shipping Address*
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Phone*
Expedited Shipping
- Check this box if you require expedited shipping. You will need to provide your FedEx account number.
FedEx Account Number
Select the study and the number of supplies and kits you need for specific timepoints. You may order kits for multiple timepoints.
Study Number*
Thermosafe Shippers
Tempus Kits and Supplies
RareCyte Kits and Supplies
Airbills for HCRN
FedEx Labels Addressed to Labs
FedEx Labels Addressed to HCRN
Ambient Shippers
Pre-Screening
Pre-Op
Radical Prostatectomy
Screening
Screening Tissue
Pre-Treatment
Pre-Treatment biopsy
Pre-Treatment surgery
Pre-Treatment - Ct guided Bx
Pre-Tare
Prior to C1D1
4 Weeks Post Tare (Arm A)
12 Weeks Post Tare (Arm A)
3 Months
6 Months
12 Months
Stool Kit
Cycle 1 Day 1
Completion of C2 treatment
Cycle 1 Day 1 (90-min. post)
Cycle 1 Day 1 (Adjuvant)
Cycle 1 Day 1 (Arm A)
Cycle 1 Day 1 (Arm B)
Cycle 1 Day 1 (Induction)
Cycle 1 Day 1 (Consolidation)
Cycle 1 Day 1 (Crossover)
Cycle 1 Day 1 (Neoadjuvant)
Cycle 1 Day 1 (PK and Complement Factors)
Cycle 1 Day 3
Cycle 1 Day 8
Cycle 1 Days 11-15
Cycle 1 Days 12-14
Cycle 1 Day 15
Cycle 1 Day -15
Cycle 1 Day 21
Cycle 1 Day 22
Cycle 1 Day 29
Cycle 1 Day 43
Cycle 2 Day 1
Cycle 2 Day 1 (Arm A)
Cycle 2 Day 1 (Biopsy)
Cycle 2 Day 2
Cycle 2 Day 15
Cycle 2 Day 22
Cycle 2 D15-28
Cycle 3 Day 1
Cycle 3 Day 1 (Arm A)
Cycle 3 Day 1 (Consolidation)
Cycle 3 Day 15
Cycle 3 Day 22
Cycle 3 Day 22 - Arm B Only
Cycle 4 Day 1
Cycle 4 Day 1 (Arm A)
Cycle 4 Day 1 (Crossover)
Cycle 4 Day 22 - Arm B Only
Cycle 5 Day 1
Cycle 5 Day 1 (Arm A)
Cycle 5 Day 1 (Arm B)
Cycle 5 Day 22
Cycle 6 Day 1
Cycle 6 Day 1 (Arm A)
Cycle 7 Day 1
Cycle 7 Day 1 (Arm A)
Cycle 8 Day 1
Cycle 8 Day 1 (Arm A)
Cycle 8 Day 22
Cycle 9 Day 1
Cycle 10 Day 1
Cycle 10 Day 1 - Arms A-2/B Only
Cycle 11 Day 1
Cycle 11 Day 1 - Arm A-1 Only
Cycle 11 Day 22
Cycle 12 Day 1
Cycle 13 Day 1
Cycle 13 Day 1 - Arms A-2/B Only
Cycle 16 Day 1 - Arms A-2/B Only
Cycle 19 Day 1 - Arms A-2/B Only
Cycle 22 Day 1 - Arms A-2/B Only
Cycle 25 Day 1 - Arms A-2/B Only
C4D1
Every Even Cycle
Day 1 (Arms 1 & 2)
Day 1 Whole Blood Germline (Arm 2 Only)
Day 14 (Arm 1 Only)
Day 15 (Arms 1 & 2)
Week 4 Day 1
Post-Treatment - Ct guided Bx
On-Treatment Biopsy
Before Surgery
Before Vaccination
Pre-Cystectomy/Safety Visit
PD/Safety Visit
Progression Following Response
Cystectomy
Post Cystectomy Follow Up #1
Post Cystectomy Follow Up #2
Post-Cystectomy
Safety Follow-up
Safety Visit
D30/Safety
D30/Progression
Day 30 Safety/Progression
Safety Visit (Day 90)
Safety Visit (Relapse)
Relapse
PK and Immuno Kit - First 12 patients only
Arm A - Serum PK & ADA (all visits)
First Post-Screening Imaging
First Recurrence
Second Recurrence
Standard of Care Surgery
Standard of Care
Surgery
After Resection
End of Treatment
End of Treatment/Follow-up
End of Treatment/Progression
Progression
Progression/D30
Progression/D30 Safety Visit
D30/SoC Surgery
D30 Safety Follow-Up
Progression/Safety Visit
Progression/Safety Visit
M3 Progression Follow-Up - Arm A-1 Only
M6 Progression Follow-Up - Arm A-1 Only
M9 Progression Follow-Up - Arm A-1 Only
M12 Progression Follow-Up - Arm A-1 Only
M15 Progression Follow-Up - Arm A-1 Only
Progression/Follow-Up
Progression/Safety Follow-Up
Safety Follow-Up/Relapse
Follow-up
Follow-up #1
Follow-up #2
Recurrence
Re-evaluation
Restaging Scan
Restaging
Post Restaging / D30 Safety Visit
Surgery
Surgery Sub-Study
Post-Surgery (1 month)
Post-Surgery (6 months)
Post-Treatment (3 months)
Post-Treatment (6 months)
Post-Treatment (9 months)
Post-Treatment (12 months)
Post-Treatment (15 months)
Post-Treatment (18 months)
Post-Treatment (21 months)
Post-Treatment (24 months)
Post-Treatment (3 years)
First Routine Care Visit (Arms 2 and 3)
Q3 Follow Up
3 Month
3-Month Visit (Arms 2 and 3)
6-Month Visit (Arms 2 and 3)
6 Month
3 Month Post-RP
6 Month Post-RP
9 Month Post-RP
12 Month Post-RP
12 Month
18 Month Post-RP
18 Month
21 Month Post-RP
24 Month Post-RP
24 Month
Disease Assessment - M6 (Arm B)
Disease Assessment - M12 (Arm B)
Disease Assessment - M18 (Arm B)
Disease Assessment - M24 (Arm B)
Disease Assessment - C13D1 (Arm C)
Disease Assessment - C17D1 (Arm C)
Qualtek Kit
Baseline
Baseline (Phase 1)
Baseline (Phase 2)
Phase 1: Week 2
Phase 1: Week 6
Phase 2: Week 6
Phase 2: Week 12
Phase 2: Week 24
Pembro Phase of Stage 1 (Cycle 1 Day 1)
Pembro Phase of Stage 1 (Cycle 2 Day 1)
HD IL-2 Phase of Stage 1 (Cycle 1 Day 14)
HD IL-2 Phase of Stage 1 (Cycle 2 Day 28)
HD IL-2 Phase of Stage 1 (4 weeks after last dose)
Week 1 Day 1
Comments
Name
This field is for validation purposes and should be left unchanged.