Samples Submission

Please fill out this document with appropriate information and submit.
Fields marked with * must be filled.
You will receive an email with the submitted information.
Print a copy and include it with the sample shipment.

Project

Project ID *

Date

Quote reference *

Technical questions

Molecular procedure / technology *

Number of samples *

Sample description *

gDNA total RNA mRNA cDNA PCR Product Whole blood Saliva Paraffin-embbeded tissues Other:

Source (species, tissue, cell line, soil…) *

Isolation method

Sample buffer

Quantification method

Have samples been purified or concentrated?

Yes No

If yes, method used

Remarks

Sample information (PDF/Word) *

Download the model, fill it in and submit it.

SNP information (PDF/Word)

Download the model, fill it in and submit it.

Identification

Address *

Billing address (if aplicable)

Vat number *

Observations

Message

Email *