- For ALL STUDIES please complete a RELEASE OF INFORMATION SHEET and a COVER SHEET, (electronic version)
- Completed forms can be emailed to us at mosaic@cw.bc.ca
- We would greatly appreciate it if you would also consider completing an optional Tissue Banking Consent
- Please use this optional tissue banking consent form and this lab requisition to donate to the lab as a control participant for any of our studies.
Please note: Participants may have blood drawn at life labs as well, see bottom of page for Life Labs requisition.
- EPIC: Epigenetics of the Placenta in Complications of Pregnancy (Abnormal maternal serum screen IUGR, preeclampsia, preterm birth)
| Consent-EPIC_Participant | Consent-EPIC_Control | EPIC_Questionnaire |
| Consent – EPIC_Tissue Banking | C&W- EPIC_Blood req | EPIC_E-Questionnaire |
- EHR_IMPRINTING DISORDERS AND UNIPARENTAL DISOMY (Epigenetics of Human Reproduction)
Consent-EHR_Participant Consent-EHR_Parental Consent- EHR_Tissue Banking C&W- EHR_Blood req
CheekSwab- EHR_cheekswab req (contact us for kit)
- WOMEN WITH RECURRENT MISCARRIAGES OR A TRISOMIC PREGNANCY {not actively recruiting}
Consent – Subject Questionnaire Consent – Tissue Banking C&W Blood req - WOMEN WITH SUCCESSFUL PREGNANCIES AT/OVER AGE 37 {not actively recruiting}
Consent – Control Questionnaire Consent – Tissue Banking C&W Blood req - WOMEN WITH PREMATURE OVARIAN FAILURE (POF) {not actively recruiting}
Consent – Subject Questionnaire Consent – Tissue Banking C&W Blood req - PRENATAL DIAGNOSIS OF MOSAICISM (or chimerism)
Consent – Subject Consent – Parent Questionnaire Consent – Tissue Banking C&W Blood req - POSTNATAL DIAGNOSIS OF MOSAICISM (or chimerism)
Consent – Subject Consent – Parent Questionnaire Consent – Tissue Banking C&W Blood req - DIAGNOSIS OF HYDATIDIFORM MOLE, TRIPLOIDY or PLACENTAL MESENCHYMAL DYSPLASIA
Consent – Subject C&W Blood req Consent – Subject child Consent – Tissue Banking - X CHROMOSOME INACTIVATION STUDY
Consent – Subject C&W Blood req Consent – Subject child Consent – Subject child 7 – 14 years Consent – Tissue Banking
Life Labs (MDS)
| LifeLabs Blood requisition | Life Labs Locations | |
Forms for Shipping
Blood and DNA Shipping form |
Placenta Shipping form |
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