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Lab Testing Sample Submission Form
Digital Form & Payment Gateway - (Patreon Members save up to 75% on services). Please include entry# when mailing samples. Mailto: Introspective Arts LLC, 3961 N Lake Orlando Prky, #1709, Orlando, FL, 32808
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Lab Testing Services
Enter your sample quantities & member codes below
$200.00
$
200.00
Analysis Type
Quantity
Price
The Cultivar Cup
$200.00
$
200.00
Basic HPLC
$100.00
$
100.00
Extended HPLC + Y&M
$200.00
$
200.00
Control Study A/B
$100.00
$
100.00
Y&M, Moisture &/or DNA
$100.00
$
100.00
Beta Glucan, Beta Carboline, Vitamins
$400.00
$
400.00
Item subtotal:
$0.00
$
0.00
50/50 Tickets
Raffle
$5.00
$
5.00
Quantity
Item subtotal:
$0.00
$
0.00
Number of Samples Submitted:
Sample Lists &/or any additional info: (Sample Name(s) & any series or batch numbers):
#1. #2. #3. #4. #5.
(for multiple samples or any additional sample info - # list for multiple entries)
Your Name: (confidential)
*
First Name
Last Name
Reporting Type (*All TCC Entries are by Default Public)
Public
Private
Public - Anonymous
Name for Reporting on COA:
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(Group, Business or any Nik-Name)
Email :
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(example@email.com - members use patreon email)
Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Member Status:
MMFAM Regular Member
MMFAM Testing Tier Member
TTF Regular Member
TTF Magic Tier Member
NFT holder
Patreon Member Referral
GordoTek Member
TrueLife Member
Non-member
MycoTrophic
Haight Street Shroom Shoppe
Oklahoma Fungi
Other
Category for Reports:
Psilocybes
Panaeolus
Extracts
Functional Mushroom (Cordyceps, Lions mane)
Cacti
Phenethylamines
Cannabis
Edibles
Other
Sample Type:
Raw material (flower, fruit)
Extract Dry (shatter, wax, powder)
Extract Liquid (vials, bottles)
Edible (food product)
Crystal (purified Iso)
Edible (drink)
Other
Species: (if applicable)
Psilocybe Cubensis
Psilocybe Cyanescens
Panaeolus Cyanescens
Psilocybe Tampanensis
Psilocybe Natalensis
Psilocybe Subtropicalis
Psilocybe Azurescens
Psilocybe Caerulescens
N/A
Hybrid
Psilocybe Zapatecorum
Panaeolus Bisporus
Psilocybe Aztecorum
Other
Species: (if applicable)
Sativa
Indica
Hybrid
N/A
Other
Species: (if applicable)
MHRB
Acacia
N/A
Cacti
Other
Harvest Date:
-
Month
-
Day
Year
Date
Approx Submission Date:
-
Month
-
Day
Year
Date
How Where the samples Dried?:
Dehydrator
Air Dry
Freeze Dried
Fresh
Other
How Was Storage Stored?:
Paper Bag
Plastic Bag
Vac Sealed
Jar
Argon Gas
Made Into Capsules
Powdered
Whole
Fresh Extract
Dry Extract
Other
Lighting:
LED
Outdoor
HPS
Fluorescent
Incandescent
Other
Habitat:
Outdoor
Indoor
Martha/ Tent
Tote
Bag
Other
Growth Attributes:
Rows
Slow
Fast
Average
Germination
Colonization
Fruiting
Growth Medium/ Nutrients:
Rows
Included
None
Grain Base
Manure
Wood
Straw
Gypsum
CoCo Choir
Vermiculite
Additives
Additives: (any additives used in this batch?):
Gypsum
Oyster Shell
BCAA
Wood
Charcoal
Dextrose
DCP
Yeast/ Peptone
Coffee
Worm casting
Guanu
Lotus Feed
Commercial feed
Proprietary Blend
Lime
Calcium
Nitrogen
Phosphorus
Manure
Karo
Other
For Extracts: (extract tech/ solvents used):
Methanol
Ethanol
Butane
Di-Ethyl ether
Full Spectrum
Isolate
Distillation
A/B Pull
STB Pull
Re-purified
Naptha
Heptane
Live Rosin "Press"
Lemon Tech
Water H2O
Other
Additional cultivation/ Growing attributes, ex. Additives, Lighting, nutrients, fruiting conditions & other observations
Attributes - Here you can be specific or make lists
Submit your own Sample Photo (optional for reporting & NFT minting)
Upload a file: Any images, sequence or previous data, COA, etc.
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any relevant data to connect?
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Has this sample or any of these samples been used to generate a trip report via the Fungi.Tech APP?
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