Accreditation Interest Form

Tissues Handled

Please specify what type(s) of deceased donor tissue your establishment handles.

Cardiac Tissue	Cellular Tissue
Musculoskeletal Tissue	Skin
Vascular Tissue	N/A

Please specify what type(s) of living donor tissue your establishment handles.

Autologous Tissue	Birth Tissue
Reproductive Tissue	Surgical Bone
N/A

Please specify what activity(ies) your establishment performs.

Authorization	Distribution
Donor Eligibility Determination	Donor Screening
Informed Consent	Processing
Recovery	Storage

Does your establishment manufacture human tissue products regulated as drugs, biological products, or medical devices that have not received marketing clearance from the FDA via BLA (biologics license) or PMA/510(k)?

Yes

No

Background

When did your establishment begin operations?

Are you familiar with the Standards for Tissue Banking?

Yes

No

When do you intend to apply for Accreditation?

0-3 months3-6 months6-9 months9-12 months12+ months

Annual Gross Tissue Revenue

AATB defines gross tissue revenue as "the revenue received for the recovery, processing, storage, and/or distribution of tissue products" during your fiscal year

Do you have any questions for the AATB Accreditation Team?

I understand that the application process for new establishments seeking accreditation takes approximately 6-9 months to complete and that all information submitted will be reviewed and approved by AATB Staff prior to the distribution of any application materials.