Human Biological Samples Transfer Agreement

Parties

Provider Organization:

Recipient Organization:

Background

Definitions

1. Transfer of Samples

2. Use of Samples

3. Compliance

4. Confidentiality

5. Intellectual Property

6. Publication

7. Return or Destruction of Samples

8. Term & Termination

9. Liability

10. General Provisions

Annex 1: Description of Samples

Sample Type Quantity Description

Provider Organization

Name:

Signature:

Date:

Recipient Organization

Name:

Signature:

Date: