Material Request Form

Material Request Form

Thank You For Your Interest In Versiti Biomaterials

As a research organization, Versiti is committed to the highest quality standard for the provision and traceability of biomaterials used for research, further manufacturing and/or commercial purposes. Please provide one of the following documents when submitting an order for biomaterials:

  1. IRB Protocol and Approval
  2. IRB Protocol and Waiver/Exemption
  3. Letter of Intent and Protocol
  4. Biologics License Application

Versiti is a world-renowned organization committed to accelerating innovation by enhancing and expanding our products and services to meet the needs of the medical research community and biotech institutions.

Upload Your Request Form and Documentation

Download the Letter of Intent and Material Request Form using the links below. After you have completed them attach them using the upload functionality. We will be responding shortly to your inquiry and will be gathering additional information not included in these initial documents. Please be aware additional documentation may be required.

Depending on product specifications, 72 hour advance notice is required for processing and fulfillment.

Sample Letter and Material Request Form

Required Forms

Please download and complete the sample Letter of Intent and the Material Request Form and attach below. You will also need to upload one of the additional forms of documentation from the section below to complete your request.


Additional Documentation

Choose one or more of the documentation choices below.

Leukopaks
Versiti’s peripheral blood mononuclear cell (PBMC) product is an enriched, fresh leukapheresis product composed of high concentrations of monocytes and lymphocytes, but may also contain lower concentrations of platelets, plasma and red cells.
Non-Transfusable Products for Research
As a blood center, Versiti is committed to stewardship of the precious gift that our donors provide. We make products that have expired or are found to be unsuitable for transfusion available to help advance new frontiers in science and medicine.
Prospective Blood Product Collections
Versiti’s expertise in blood collection, apheresis procedures, and donor management ensures procurement of the highest quality human blood products required to support your unique research study needs.