Quote Request
Principal Investigator
Name and contact info for the requesting lab (academic) or the project/division leader (industry)
First Name *
Last Name *
Title *
Institution *
Department
Email *
Phone Number *
Name and contact info for the requester, if not the PI.
First Name
Last Name
Title
Email
Phone Number
Billing Information
Institution *
Required
COA (Chart of Accounts)
If applicable
Fund Manager
If applicable
Project and Order Information
Project Title *
Project Description *
Short description of the objective of the study?
Sample Type *
Required
Species *
If other, please specify
Types of Analysis
Fatty Acyls and Eicosanoids
Glycerophospholipids
Glycerolipids
Sphingolipids
Cholesterol Esters
Sterols/Oxysterols
Other Analysis
Please provide a specific analysis (ex. sphingosine-1-phosphate, protein concentration, etc.)
Number of Samples (10 sample minimum) *
Amount of each sample *
Please indicate units (volume/weight)
Desired Date of Completion
MM
/
DD
/
YYYY
Sample Handling
Sample Storage Conditions
Specific conditions the sample need to be in?
Hazards
If other hazards, please indicate
How would you like us to handle samples after testing? *
If 'store temporarily', how long should we keep it?
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