Blackrock Utah Array Quote Request Form
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This is the OFFICIAL form where you can define the configurations of your arrays. Please make sure you fill out the form carefully and include any special requests on this form. Any prior communications and discussions outside of this form is invalid and will not be considered.

All array orders are custom and no refunds or exchanges are allowed.

If you need more information with anything on this form please contact our sales at sales@blackrockmicro.com.

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General Information
Neuroport Array and inserter (Sterile)
Organization Name *
Name of the university, hospital or organization the order will come from.
Principal Investigator *
Name of the main principal investigator of the lab
Your Name *
Your Email Address *
Your Phone Number *
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