CLC Questionnaire

Name*

First Last

Institution*

Job Title*

Email*

Phone*

Fax*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Website

Tech Transfer Contact Name*

Tech Transfer Contact Email*

Tech Transfer Contact Phone

Preferred Format For Receiving Compounds

(select all that apply)

96-well plate
384-well plate
glass vial
1.5 mL Eppendorf
Matrix minitube

Special formatting requirements for compound plates:

Specify rows/columns to be left blank for controls, etc.

Compound Amount Required

Our standard stock supply is 0.2 micromoles dry film, to be reconstituted in DMSO to desired by concentration by recipient. If this is not sufficient for your needs, please elaborate below.

0.2 micromoles dry film
other

Special Compound Amount Requirements

Assay Details

Please describe the area of biology you are studying and your assay (2-3 sentences only).

Assay Specificity

Briefly indicate any evidence you have that your assay provides both a sensitive and specific readout for your biological question of interest (2-3 sentences only).

References

Please list one review article on the pathway or protein targeted by your screen (not necessarily authored by you) that would provide sufficient background reading to familiarize BU-CMD personnel with your assay.

Is there a positive control condition for your assay which replicates the phenotype of a desired screening positive?

Yes
No

If yes, please explain this condition below:

Assay Type

Phenotypic
Biochemical
Other

If "Other," please elaborate

Protein

Cell Line

Transfected Gene (optional)

Modulator

For modifier screens only.

# of cells per well

Incubation Time

Readout

Fluorescence
Luminescence
Absorbance
Microscopy

How many compounds do you anticipate screening?

Average full collection distributions are 2000-3000 compounds, with smaller numbers available as focused sets.

Secondary Assays

Explain any secondary assays that will be used for further characterization of compounds which score as positives in your primary screen. Also describe how they will help prioritization of positives.

Timeline

Please provide an estimate as to when data will become available. If your assay is still being developed, please include a realistic estimate as to when your assay will be ready for BU-CMD compounds.

Have you already conducted a screen using this assay on other compound libraries?

Yes
No

Are you capable of screening compounds immediately?

Yes
No, need more time
No, need additional resources

Funding source for your research

Private
Commercial
NIH

Data Sharing

Are you agreeable to providing follow-up information to other BU-CMD biological collaborators on the results of your screening (e.g., details of the assay, number and potency of "hits," the structure(s) of "hits" as related to the molecular or cellular target)?

Yes
No

Collaborations

If hits are identified in your screen, would you be interested in partnering with the BU-CMD in collaborative medicinal chemistry projects?

Yes
No

Interest in screening*

Repository compounds (free of charge and requires 3-way MTA)
BU compounds only (may incur fees and requires 2-way MTA)

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