MITOMAP: Unpublished Human MtDNA Polymorphisms Submission Form

  • Submit unpublished human mtDNA polymorphisms (point mutations, micro-insertions, or micro-deletions).
  • Fields marked with red text must be completed
  • After each entry, you will have the option to make additional entries.
  • To modify data previously submitted, please send an e-mail to mitocite@uci.edu with the 'MITOMAP mtDNA Sequence Data #' and the required modifications.
Submitter Information:
Last Name
First Name
Middle Name/Initial
Email
Organization
Country
Address
Lab Information:
Lab Chief/PI Last Name
Lab Chief/PI First Name
Lab Chief/PI Middle Name/Initial
Lab Chief/PI Email
Other Contributor(s)
DNA Information:
Nucleotide Position
Nucleotide Change e.g A-G
Locus/Gene
Amino Acid Change
(If yes, please specify) e.g. R-H
Method of detection
Heteroplasmy detected
Please assign a unique sample identifier to the individual(s) whose DNA is being reported. If you do not have a unique identifier, please create one. Use alpha-numeric characters only and do not use family names to ensure patient confidentiality. This ID will allow determination of "linkage" (mutations found in the same individual).
Sample Identifier
Other Information:
Patient Group/Phenotype e.g LHON, diabetes, control/normal
Racial/Ethnic Group e.g. Bushman, Hispanic, Eskimo
Country or Region of Origin e.g. Canada, Japan, Siberia
Haplogroup
Tissue Tested
Notes or Any Other Relevant Information
Verification:
Required: Enter the sequence shown in the image below.
Return to MITOMAP home page