Statement of Work
All information will be helping us to create an accurate quote for you and avoid misunderstandings
This is a trial questionnaire, if you have any comments or advice please ad those at the bottom of this form

Our approach is a logical one, you choose a main category, then a subcategory, where necessary a second sub- category and or a (customized) quantity before answering the mandatory general questions, in section 501. Just follow the numbers as indicated.
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Email *
Company Name *
First Name *
Last Name *
Contact Phone Number *

Please describe your Project briefly
(so that we can motivate & educate donors and we can understand your project better; no names, no personal or business details will be shared or revealed):

 *
Project Deadline
(By when would you -at the latest- like to receive your product?) If earlier is possible we will contact you of course.. *
MM
/
DD
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YYYY
Unique Donors or Pooled product
 *
How many Unique Donors or how many Pooled Samples? *
Are you looking for Repeat Donor(s) over time? 
 *
Elaborate on Repeat Donor(s)
(if not applicable please type n/a)
 *
Donor Inclusion Criteria
(if not applicable please type n/a)
Age, Gender assigned at birth, Blood Type, BMI, Tobacco use, Infectious Disease testing, Weight, Height, etc.
 *
Donor Exclusion Criteria
(if not applicable please type n/a)
 *
Donor Categories:
(Normal Human / Diseased Human / Non-Human Primate 
(If more than one cohort, please fill out a separate questionnaire for each cohort)
 *
101: If "Normal Human" then
Clear selection
101A (i): (4 questions) If "Normal Whole Blood" product then
101A (ii): If Normal WB / Plasma or Serum, then Blood Type:
101A (iii): If "Normal WB, then
101 A (iv): If WB Plasma or Serum, then
101B: If "Normal Peripheral Blood" product, then
Clear selection
101B -01: If Normal PB Leukopak, then
101B -02: If Normal PB Platelets, then
101B -03: If Normal PB Platelet Rich Plasma, then
101B -04: If Normal PB Mono-Nuclear Cells (PBMC's), then
101B -05: If Normal CD3+ Pan T Cells, then
101B -06: If Normal CD4+T Helper Cells, then
101B -07: If Normal PB CD4+/CD25+ Regulatory T Cells, then
101B -08: If  Normal PB CD4+/CD45RA+/CD25- Naïve T Cells, Or Normal PB CD4+/CD45RO+ Memory T Cells, then
101B -09: If  Normal PB CD8+ Cytotoxic T Cells, then
101B -10: If  Normal PB CD8+/CD45RA+ Naïve Cytotoxic T Cells, then
101B -11: If  Normal PB CD14+ Positively Selected Monocytes, then
101B -12: If Normal PB CD14+ Untouched Monocytes, or
Normal PB Positively Selected CD19+ B Cells or Normal PB Untouched CD19+ B Cells, then
101B -13: If Normal PB Untouched CD19+/IgD+ Naïve B Cells, then 
101B -14: If  Normal PB Untouched CD56+ NK cells, or
Normal PB CD56+ Positively Selected NK cells,  then 
101B -15: If  Normal PB Red Blood Cells / Mature Erythrocytes, then
101B -16: If Normal PB Neutrophils, then 
101B -17: If  Normal PB Eosinophils, then 
101B -18: If  Normal PB Basophils, then
101C: If Normal Mobilized, then
Clear selection
101C -01: If Normal Mobilized Leukopak, then
101C -02: If  Normal Mobilized PB Mononuclear Cells (PBMC's), then
101C -03: If  Normal Mobilized PB CD34+ Stem Cells, then
101C -04: If  Normal Mobilized PB Depleted CD34+ Stem Cells, then
101D: If  Normal Cord Blood, then
Clear selection
101D -01: If  Normal Unprocessed Cord Blood, or
Normal Unprocessed, Pooled Cord Blood, then
101D -02: If  Normal CB Plasma or
Normal CB Serum, then
101D -03: If  Normal CB Mononuclear Cells (CB-MC's) then
101D -04: If Normal CB CD4+ T Helper Cells, or
Normal CB CD4+/ CD45RA+ Naïve T cells, then
101D -05: If Normal CB CD8+ Cytotoxic T Cells, or
Normal CB CD14+ Monocytes,  then
101D -06: If Normal CB CD19+ B Cells, then
101D -07: If Normal Human CB CD34+ Stem Cells (Single Donor), then
101D -08: If Normal CB CD34+ Stem Cells (Pooled Donors), then
101D -09: If Normal CB CD34+ Depleted Stem Cells (Pooled Donors), then
101D -10: If Normal CB CD56+ NK cells
101D -11: If Normal CB Pan T cells
101 E: If Normal Bone Marrow, then
Clear selection
101E -01: If Normal BM Aspirate, then
101E -02:  If Normal BM Mononuclear Cells (BM-MC's), then
101E -03: If Normal BM CD34+ Stem Cells, then
101E -04: If Normal BM Depleted CD34+ Stem Cells, then
201: If Diseased Human, please specify disease here, then continue at 201 A through 201 D (4 questions)
201 A: If Diseased Whole Blood, then
201 B: If Diseased PBMC's, then
201 C: If Diseased Plasma or Serum, then
201 D: If Diseased Leukopak then
301: If Non-Human Primate, then (please select a minimum of 1 species and 1 product)
301 A: If Non-Human Primate Whole Blood, then
301 B: If Non-Human Primate PBMC's, then
301 C: If Non-Human Primate CD3+ Pan T Cells, then
301 D: If Non-Human Primate Bone Marrow Aspirate (BMA), then
501: Anticoagulants / Tubes  of your choice *
Required

Collection Protocol Requirements
(You can describe your customized collection protocol in the next question).
For our standard collection and processing protocols see our websites https:www.firstchoicebio.com or https://quickcells.com *
Your Customized Collection Protocol(s)
Processing Protocol Requirements
(You can describe your customized Processing Protocol in the next question). For our standard collection and processing protocols see our websites https:www.firstchoicebio.com or https://quickcells.com *
Your Customized Processing Protocol(s)
Aliquots *
Required
Your Custom Aliquot Description
Storage Conditions
for the end product while in our custody.
If Customized, pls describe in next question *
Customized Storage Condition(s)
Shipment Frequency.
A one off batch shipment / weekly / bi-weekly / monthly / customized, please explain in next question *
Customized Shipping Frequency
Shipping Conditions for your end product while in Transit. *
Shipping Options.
Same Day delivery =< 2 hrs after last collection / < 75 miles from collection center.
Customized Courier Services, pls enquire.
Overnight Courier Services =< 8.00 AM
Global Customized Courier Service =< 24 hours please enquire.
FedEx First Overnight =< 8.00 AM*
FedEx Priority Overnight =<10.30 AM*
FedEx International First*
FedEx International Priority Express*
FYI: * FedEx does not take responsibilities for delayed deliveries.
Customized according your plan (explain in next question)
 *
Elaborate on your Customized Shipping Option
Can we use your FedEx Account?
Please provide your number here
Receiving Options
Specific date (see next question)
Monday through Friday (as soon as possible, we will contact you)
Weekends included (International courier)
 *
Specific Receiving Date
MM
/
DD
/
YYYY
Shipping Address
(If available please include an email address for Shipping & Receiving)
 *
Billing Address if different
(please include an email address for Accounts Payable)
Your Comments and Notes
This is a trial questionnaire, if you have any comments or advice for us -besides making it shorter- please ad those here, or call Jan at +1-707-333-0902
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