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Steps to becoming a CCCTPSR member:
1. Complete a CCC application (Located below these steps on this page).
2. Sign the Tissue Procurement Service (TPS) Data Use Agreement. Please
contact Traci Jordan to get
a copy of the form.
3. Provide a copy of your human use approval to receive tissue from the CCCTPSR.
Either a full or expedited approval from your Institutional Review Board.
4. Submit all three documents (CCC application, TPS Data Use Agreement, IRB approval)
via fax to the CCCTPSR at 614-293-7013.
Application Form:
CCC Application (.pdf format)
Tissue Donation Form:
Informed consent
for the donation of body tissue and fluid for research purposes (.pdf format)
TPS Data Use Agreement:
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You will need Acrobat Reader to be
able to read the files. Click on the Acrobat Reader
image to download it.
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