Sample Submission Form

Sequencing Only 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.
Instrument Required *
HiSeq Options *
If not found, please select Other option in Instrument Required field and specify in Other Instruments box.
MiSeq Options *
If not found, please select Other option in Instrument Required field and specify in Other Instruments box.
NextSeq Options *
If not found, please select Other option in Instrument Required field and specify in Other Instruments box.
NovaSeq Options *
If not found, please select Other option in Instrument Required field and specify in Other Instruments box.
Other Instruments *
Please specify other instruments required.
Total Output Required *
Number of lanes or flowcells, or total size of data output
Need Pooling? *
Need Demultiplexing? *
Phix? *
Phix % *
Between 1 to 100
Custom Read1 Primer?
Full flowcell is required for custom primer (not apply to HiSeq).
Custom Read2 Primer?
Full flowcell is required for custom primer (not apply to HiSeq).
Custom Index1 Primer?
Full flowcell is required for custom primer (not apply to HiSeq).
Custom Index2 Primer?
Full flowcell is required for custom primer (not apply to HiSeq).
Mix Custom Primer with Illumina Sequencing Primer?
Full flowcell is required for custom primer (not apply to HiSeq).
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

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

checked
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 sequencing only 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
**we do not accept samples in PCR strips

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

Please fill the template and upload your file.
Should be Empty:

Sequencing Only Project

Shipping Instructions

Client Information

Project Information

Data Delivery

Sample Information