Lifespan Clinical Research Center

Lifespan Clinical Research Center Freezer Storage Intake Form

The Lifespan Clinical Research Center will attempt to accommodate any short term request for -80C freezer space for storage of research specimens in the Multiphasic Building of Rhode Island Hospital. Please note, approval must be granted prior to storing any specimens as space is limited. Please submit the form below and someone will reach out. If you have any questions, please contact Brittany Phipps 401-793-8571. Thank you!

Basic Information

Requester's Name
Investigator's Name

Emergency Contact

Please provide an emergency contact, name and phone number, if specimens need to be re-located in the case of an emergency (i.e. power failure of freezer):
Emergency Contact Name

Storage Details

Specimen Types

Additional Information