Sample Submission Form - Library Preparation and Sequencing

Library Preparation and Sequencing Project

Sample Submission Form
Shipping Instructions
Ship Samples to:

Attention: BPS Team

Admera Health, LLC

126 Corporate Blvd

South Plainfield, NJ 07080

United States

Contact Number: (908)-222-0533 ext. 2002

Shipping Instructions:

1. Complete and submit this Sample Submission Form prior to shipping.

2. Include the Admera Health Quote and this Sample Submission Form (you will receive an email after submission) on your shipment package.

3. Ensure your samples arrive between Monday and Friday to avoid samples sitting over the weekend.

4. Ship samples using recommendations from Sample Submission Guideline: Click Here to Download.

Sample Storage Policy:

1. RNA/DNA samples will be stored for 3 months from the original date of sample receipt.

2. Final libraries are stored for 6 months from the original date of sample receipt.

3. If you require a longer storage time, please send us your request as additional cost may be involved.
Client Information
Customer Name *

First Name Last Name
Institution/Company *
Email *
example@example.com
Project Information
Project Type *
Admera Health Quote *
Please enter TBD if you don't have one.
Project ID
PM Assigned
Platform
Platform Project ID
Payment Information
PO number, credit card, etc.
Services Required *
10X Services Required *
Sample Type
Do you need Extraction? *
Do you need Tissue Dissociation? *
Extraction Kits *
Extraction Kits Required *
Please provide specific extraction kits.
Library Prep Kits *
Library Prep Kits Required *
Please provide specific library prep kits.
Other Instruments
Please specify other instruments required.
Output per Sample *
Number of million reads, or size of data output
Data Analysis? *
Did you send a completed Data Analysis Questionnaire? *
Please select and download the corresponding Data Analysis Questionnaire: Click Here to Access.

Please fill the DAQ and upload your file.
Upload Your Data Analysis Questionnaire *

Please select and download corresponding DAQ provided.
Cancel of
DAQ Received

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Special Instructions
TAT (days) - Calendar
Calendar days for old quotes
TAT (days) - BD
Business days, put 0 if quote is in calendar days
Expedited

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IQC/FLQC Reports

Need FLQC Report w/ Images Need FLQC Report No IQC Report No QC
Comments Lab PM
Comments PM Only
Data Delivery
We can accommodate BaseSpace transfer, FTP accounts, AWS S3 bucket uploads, and others.

Data transferred via Basespace account will be stored for 2 months after delivery notification.

Data transferred via FTP account will be stored for 3 weeks only after delivery notification.

Please download locally to prevent data loss.
Data Transfer Method
Data Transfer Account Information
Please enter BaseSpace/AWS S3/FTP information if available.
Optional Data Delivery Requests (please specify)
Note: There may be an additional charge.
Sample Information
**we do not accept samples in PCR strips

Please download the sample information template for library prep with sequencing projects: Click Here to Download.

Please fill the template and upload your file.
**we do not accept samples in PCR strips

Please download the sample information template for 10X library prep with sequencing projects: Click Here to Download.

Please fill the template and upload your file.
Upload Your Sample Information File *

Please download and use the template provided.
Cancel of
Should be Empty:

Library Preparation and Sequencing Project

Shipping Instructions

Client Information

Project Information

Data Delivery

Sample Information