Pathology Partners

Pathologists and pathology specialists are an essential component of the brain recovery process and a pathology partner (PP) participates in every brain donation.  We use the term “pathology specialist” to refer to pathologists’ assistants, pathology technicians, and dieners.

We help with nearly 200 brain donations each year, a number that has grown each year since we started our work in 2007.  We also have 100 donations that have been organized, but for which donors have not yet passed.  As our operations grow, we need more and more PPs to help us to execute our mission.  This page describes how BSN works with PPs, many of whom become repeat providers.

Please read through these requirements to understand our expectations.



BSN’s mission is to facilitate and organize the recovery of brains of persons diagnosed with any neurological disorder.  Brain donation provides families with a confirmed diagnosis (from a neuropathology report) and supports research into the causes, treatments and cures for neurodegenerative disorders.

As almost all of BSN’s recovered brains are shipped to the Mayo Clinic in Jacksonville, Florida, for autopsy, we use the Mayo Jacksonville consent form (see below) and follow the Mayo Jacksonville protocol which requires that brains be recovered within 24 of death.  BSN arranges for delivery of shipping containers to the pathology partner (PP) by Mayo.  PPs are paid directly by the family, though BSN guarantees that the PP will be paid for their work.

Some brain donations are planned in advance, typically when the donor begins hospice care.  Half are organized when end-of-life is imminent (hours, days away).  Some are organized only after the donor has passed.  BSN strongly prefers to make donation arrangements in advance.  We know you do as well.


Mayo Clinic Protocol

Pathology partners (PPs) must be able to follow the Mayo Jacksonville protocol for removing the brain, separating the brain hemispheres, preserving the tissue prior to shipping, and separately shipping the two brain hemispheres.

The harvest should be performed as soon as possible after death, preferably within 12 hours, though up to 24 hours is still acceptable. Brains recovered after this interval are not accepted by the Mayo Clinic.  The time lapse between death and autopsy should be noted as well as the fresh brain weight when drained of CSF.  This information should be recorded on Mayo’s Autopsy Information Form included with each hemisphere.

The brain is half frozen (right hemisphere) and half fixed (left hemisphere). Remember that the words “frozen” and “right” both have the letter “R”.  Split the brain down the middle through the corpus callosum, cerebellar vermis, and brainstem. Put the right hemisphere in a plastic bag into the coldest possible freezer (preferably at -70˚C).  If no freezer is available at the place of procurement, store the right hemisphere in dry ice.  If no dry ice is available at the place of procurement, store the right hemisphere in wet ice until (and this period should be very brief) you can store the hemisphere in a suitable freezer or in dry ice.

In order to prevent distortion of the specimen, put the medial aspect of the brain down flat, so that it will freeze in its normal shape. The left hemibrain is simply immersed in formalin, buffered to neutrality.

If you do not have a suitable freezer (-70C is preferred; -30C is acceptable) for storage, you may use a suitable storage container and purchase dry ice.  If you increase your fee to the family to cover this expense, this must be disclosed in advance so that the family knows the total fee.

See requirements and tips for shipping the brain hemispheres at bottom of this page.

COVID-19 UPDATE:  Mayo Jacksonville is accepting brains from donors who have tested COVID-positive.  Of course, this tissue should be clearly identified as COVID-positive.

COVID-19 UPDATE:  In May 2020, the risks of contracting COVID-19 from the brain removal operation are still not fully understood.  PPs may want to adopt techniques that minimize the aerosolization of fluids (e.g. placing a wet towel and/or plastic sheet over the donor’s head and saw when using a bone saw).


Technical Qualifications and Requirements

Pathology partners (PPs) must have access to:

  • Bone saw, scalpels, etc.
  • Formalin and container to immerse left hemibrain completely
  • A freezer (-70C is preferred; -30C is acceptable) or dry ice sufficient to last up to 6 days (which might be longer during winter holidays and the COVID-19 pandemic)
  • Packing materials such as Ziploc-type plastic bags, chucks or paper towels

Because some families will organize viewings of the donor, incisions must be suitably closed.

Communication Requirements

BSN appreciates good communication, primarily via text and email.  BSN needs the following from the pathology partner (PP):

  • Mobile phone number that accepts texts
  • Email address

In the detailed instructions we send to families, hospice agencies, care facilities, funeral homes, and PPs, we ask for the hospice agency to alert both the PP and BSN when end-of-life is imminent (within 48 hours).  When you receive this alert, please relay it to BSN (cell 650-814-0848, email [email protected]).  We will do the same.

Also, in the detailed instructions we send to all parties, we ask for the hospice agency to first notify the PP and then BSN.  When you receive this notification, please relay it to BSN (cell 650-814-0848, email [email protected]).  Hospice is expected to provide this information:

  • Unofficial and official TOD
  • Time head icing began

Please double check that BSN has received this notification and these details.  We will do the same.   At that time, we ask you to inform us as to:

  • Time the pathology work is scheduled
  • Your need for shipping containers and dry ice as well as a shipping address

After the brain recovery is complete, we ask you to:

  1. Inform (text or email) BSN the time of brain recovery,
  2. Confirm that the family’s payment check was at the funeral home or that you have received the family’s payment online,
  3. Send the family a receipt for payment of your pathology services,
  4. Inform BSN of the FedEx tracking numbers prior to shipping and monitor the shipment of tissue to Mayo, and
  5. Send Brain Support Network the neuropathology report when it is received from Mayo (typically 3 months after death)


Financial Considerations

BSN does not set fees for pathology partners (PPs), though we do encourage you to set the fee for brain removal at or near the average in your region, which varies from $650 to $1000.  BSN can tell you the average in your region.  The national average is $750.  We want a price that is fair to the family, but we also want a price that will cover your expenses and make the project worth your time and energy…and leave you ready to do more recoveries in the future.

In all cases of brain donation to the Mayo Clinic, families pay the PP’s fee and BSN guarantees that the PP will be paid.

Grants are available from two nonprofits to cover the cost of pathology work, but only for some diagnoses or in the case of financial need.  The average grant reimbursement is $750 and not all families qualify.  (CurePSP, which at one time made grants directly to PPs, has discontinued that grant program.)

As you know, many funeral homes or cremation organizations seek to charge prep room use fees, though we discourage these entities from charging fees.  If incurred, these fees are also paid by the families.

Our standard procedure is to ask the family to leave a check, payable to the PP, at the location of the brain recovery for pickup by the PP.   Because checks are less common today, consider the new consumer-friendly bank transfer mechanism:  Zelle.

The “Zelle” service lets consumers send money to a PP, identifying that PP by the email address associated with the PP’s bank account.  Most retail banks in the US (e.g. Chase, BofA, Citigroup, Wells Fargo) offer the Zelle service.  Registration with the bank is free.  Use, via the bank’s web site, is free and transfers are made directly to the bank account of the recipient, generally the same day.


Timing and Backup Staff Considerations

As noted above, brains must be recovered within 24 hours of death; sooner is better.  Brains must be stored (half fixed, half frozen) by the pathology partner (PP) until prepaid FedEx shipping containers and dry ice are delivered from the Mayo Clinic.  Brain tissue should be shipped to Mayo on Monday or Tuesday, but never Thursday or Friday.

PPs must be available seven days per week during the day (e.g. 7am to 7pm). We never expect work to occur in the middle of the night, though this is sometimes an option for the PP.

We prefer to work with PPs who have a fully qualified back-up person or pathology service.  This person or service will only be called upon in the event that you, the primary PP, are unavailable at the time that the donor passes.


We use Mayo Jacksonville’s consent for brain procurement.  It provides space to fill in the donor’s full name, DOB, with a statement that the donor’s next-of-kin (NOK), as signatory, gives permission for brain procurement according to the Mayo protocol. Further spaces are available to fill in the name of the pathology partner (PP), location of the pathology work, transportation provider (if applicable) and to whom to release the body following the pathology work (if applicable).

Signature lines are at the bottom for the NOK, their relationship to the donor, date and time, and two witness signatures.  Instructions for use are in the footnote.  The second page spells out Mayo protocol and shipping information.  Here is a consent form sample: page 1 and page 2.

COVID-19 UPDATE:  During the time of COVID-19, the Mayo consent form, like many consent forms, now asks for only one witness signature due to social-distancing standards.

BSN will fill in all the details on the consent form for the family and deliver it to the family.  The form can be signed in advance of donor death.  In most states this form is sufficient.  In a few states (e.g. Texas) a separate form, signed after time of death, is required.

If you have a non-Mayo consent form that must be signed, please email ([email protected]) or fax (650-233-9278) it to us so we can alert the family.  Please make explicit if this consent form must be signed after the donor’s death.


Mayo’s Shipping Requirements

Left and right hemispheres are shipped in separate containers.  Brain tissue can be shipped to Mayo only on Mondays, Tuesdays, or Wednesdays (assuming no holidays on Thursdays or Fridays) for receipt that same week.  Monday or Tuesday shipment is preferred–and during the COVID-19 pandemic shipments all shipments must be sent to Mayo on Monday or Tuesday.

When ready to ship, the frozen specimen should be placed in a plastic bag (e.g. Ziploc double-seal bag) in a Styrofoam shipping container that has outside dimensions of 11 x 9 x 15” and walls that are 1.5” thick.  The cavity of the shipping container should be filled with dry ice so that the brain will not move inside the container if jostled and to keep the brain frozen for 48 hours.

The formalin fixed specimen should be wrapped in paper towels that are damp with formalin, and double-bagged in leak-proof plastic bags (e.g. Ziploc double-seal bags), and placed in a Styrofoam shipping container that has outside dimensions of 11 x 9 x 12” and walls that are 1.5” thick.  Do not fill the Ziploc bag with formalin and remove all air from the bag.    Pack the cavity of the shipping container (e.g. with air pillows) so that the brain will not move inside the container if jostled.

For both shipments, write the name of the donor and the donor’s DOB on the outer plastic bag with an indelible ink (e.g. a Sharpie).

BSN engages Mayo Jacksonville to provide reusable containers (plus dry ice for shipping, if necessary) and prepaid FedEx overnight shipping labels once the pathology work is completed.  Mayo will NOT provide containers and dry ice in advance of death.

Pathology partners (PPs) may find it more convenient to simply order their own shipping containers from Fisher Scientific or Uline and to procure their own dry ice.  Any good quality Styrofoam shipping container can be used, though pay attention if (a) the container is too small to hold enough dry ice or (b) is bigger than the Mayo standard which will require that the prepaid shipping label be updated to reflect the size/weight of the package.  

Mayo uses Sunoco containers, with 1.5” styrofoam insulation, purchased from Fisher Scientific:

  • Sonoco 321UPS  (Fisher #03-530-52)  11 x 9 x 11.9” (outside dimensions) for the fixed hemispheres: eight containers sold for $279.50 (in September 2023), shipping extra.
  • Sonoco 324UPS (Fisher #03-530-54) 11 x 9 x 14.5” (outside dimensions) for the frozen hemispheres, eight containers sold for $309 (in May 2020), shipping extra. This taller box has extra room for dry ice and can be used for shipping the frozen half of the brain.

Comparable containers are available individually from Uline with reasonable shipping fees:

  • Uline 7359, 11 x 9 x 12” (outside dimensions) for the fixed hemispheres: one container sold for $50 (in September 2023), shipping extra, but as low as $20 for overnight shipping, depending on your location.
  • Uline 11355, 11 x 9 x 15” (outside dimensions) for the frozen hemispheres, one container sold for $57 (in September 2023), shipping extra, but as low as $20 for overnight shipping, depending on your location.

Comparable containers available individually from Amazon with reasonable shipping fees:

The FedEx prepaid overnight shipping labels, prepared by Mayo, are suitable only for containers of these dimensions and corresponding weights.  Whether you use containers of these standard dimensions or have your own shipping containers and dry ice, Mayo will provide a link to a prepaid shipping label on the FedEx website.  If you use your own containers, be aware of and adhere to the dry ice labeling requirements imposed by Fedex.

The Mayo Autopsy Information Form should be filled out and sent along with the tissue in each of the two containers.  Each box (do not tie boxes together) is to be sent overnight by Federal Express, Priority One Delivery.  Both packages should be addressed to:

Dennis Dickson, M.D.
Mayo Clinic Jacksonville
Birdsall 347
4500 San Pablo Road
Jacksonville, FL 32224
(904) 953-2439 or (904) 953-7137

COVID-19 UPDATE:  Since the COVID-19 pandemic began, Mayo is shipping out containers and dry ice only on Mondays, for arrival on Tuesdays at the PP’s address.  PPs may need to store tissue for up to a week before it can be shipped.  If Monday is a holiday (e.g. Memorial Day), no containers will be shipped out that week.  This is another motivation to consider buying your own shipping container and procuring your own dry ice.


Brain Support Network’s Shipping Tips

Following are a collection of tips that may be useful to accomplish the shipping task with minimal stress and surprise.

Ideally, Ship Both Hemibrains on the Same Date – Early in the Week

  • If you have access to a suitable freezer, please hold onto the frozen hemisphere (right) until the formalin hemisphere (left) is fully fixed (7-10 days) and ship both hemispheres at the same time.  
  • If you do NOT have access to a suitable freezer, it’s best if you can provide containers and dry ice.  Mayo can provide the prepaid shipping label.  Mayo only ships out containers and dry ice on Mondays, and has a limited number of containers and limited access to dry ice.  If you needs the containers returned, place a note inside requesting they be returned with the address to ship them to.
  • The brain must be shipped early in the week because there’s no one at Mayo Jacksonville to receive the shipment on the weekends.  Never ship on Thursday or Friday, and do not ship when the next day is a holiday. Given several FedEx delays of containers with dry ice, we strongly advise against shipping on Wednesday.  Best to ship on Monday or Tuesday and track the shipments closely.


Preparing the Formalin Specimen (Left Hemisphere) for Shipping
  • When double bagging, DO NOT overfill the “inside” bag with formalin to avoid leakage/spoilage.  FedEx will suspend transport if it appears the container is leaking during transport.
  • Label the outside of the bag with the donor’s name and DOB using a dark colored Sharpie marker.  This is especially important when shipping tissue from two donations together (frozen specimens in one container and fixed specimens in a second container).  Do NOT use stick-on labels or tape, as these fall off.
  • Include a copy of the completed Mayo Autopsy Information Form.


Preparing the Frozen Specimen (Right Hemisphere) for Shipping
  • Under no circumstances should wet ice or refrigerant gel be used for shipping.  Only dry ice should be used.
  • Do not use RED biohazard bags. Dry ice damages this type of plastic.
  • Label the outside of the bag with the donor’s name and DOB using a dark colored Sharpie marker.  This is especially important when shipping tissue from two donations together (frozen specimens in one container and fixed specimens in a second container).  Do NOT use stick-on labels or tape, as these fall off.
  • Include a copy of the completed Mayo Autopsy Information Form.


Shipping Dry Ice with FedEx

  • A ‘Dry Ice’ sticker must be on the exterior of the shipping box.
  • Some pathology partners have reported that FedEx has been unwilling to pick up or accept containers with dry ice.  
    • If you want FedEx to pick up the containers, call 1-800-GoFedEx or, if you have a FedEx account, log inPlease double-check with FedEx delivery staff who pick up from a usual location as to whether they have a problem with picking up dry ice.  
    • If you want to drop off containers, corporate FedEx locations will accept containers with dry ice.  Many “FedEx Office” locations will not. If you have questions about this, please call 1-800-GoFedEx.
  • For more information about shipping with dry ice, see this FedEx webpage


Shipping Delays – Hurricanes/Weather, Federal Holidays, and Winter Holidays
  • Especially during hurricane season, between June and November, check for FedEx Service Alerts to be sure that there are no weather conditions in Florida, Memphis/Tennessee (FedEx hub), or other locations that would delay shipping. 
  • NOAA Storm Prediction webpage may also be helpful:


Record and Share Tracking Numbers

  • The pathology partner should send a cell phone photo of the shipping label to Brain Support Network via text (cell 650-814-0848 accepts texts) clearly showing the tracking numbers of the two containers. Or, send email to [email protected]