Client order form

Peptide Analysis Client Order Form

Add one row for every sample you are sending, then send the form to the lab. Fields marked * are required. Sterility testing needs two vials per sample.

Client details

We use this to reach you about your samples and results.

Client name *

Contact email *

Phone number

Date submitted

Samples

One row per sample. Include the lot or batch number where you have it.

#	Peptide name	QTY	Amount	CAS / Lot / Batch	Sample type	IPN$150	Conformity COA$100	Endotoxin$150	Heavy metal$100	Sterility$200 · 2 vials	Expedited	Line total	Remove

1 sample row Estimated total $0.00

Additional notes

Storage conditions, hazards, shipping details or anything else we should know.

Notes for the lab

Pricing

Per sample. Totals update as you fill in the table above.

Service	Price per sample
IPN (Identity, Purity & Net peptide)	$150.00
Conformity COA	$100.00
Endotoxin	$150.00
Heavy metals	$100.00
Sterility (2 vials required)	$200.00
Expedited turnaround	Quoted separately

Line total = the services selected for that sample. Quantity does not change the price. Figures are an estimate for your planning; the lab confirms the final invoice after sample check-in.

IPN $0.00

Conformity COA $0.00

Endotoxin $0.00

Heavy metals $0.00

Sterility $0.00

Estimated total$0.00

Expedited handling, if selected, is quoted separately and is not included above.

Sending this form notifies our lab team and emails you a copy. Ship your samples to the address above at your convenience and include a printed copy with the shipment.