Microbial Identification - Sample Submission Form

Microbial Identification - Sample Submission Form
Estimate Number (if applicable)
E-mail address*
example@example.com
Name

First NameLast Name
Lab Name / Lab PI or Company Name
Email address for billing (accounts payable department, purchase agent, etc.)*
example@example.com
Purchase Order Number (if credit card payment, please note "CC")*
Note: Our contact information for your purchasing department is support@poochonscientific.com
Sample Information
Sample Type*

Single colonies on plateIsolates in culture mediumOther
Please enter your sample details below, adding a new row for each sample.

Or, for large orders, you may click here to download an Excel template and upload the completed file below.
File Upload

Cancelof
Please provide any special instructions for sample processing and/or additional information relevant to your samples, sample preparation, and/or project goals.
Sample Submission
Select the date you will submit your samples*

MonthDayYear
Date
How will you submit your samples?*

I will ship my samples.I will drop my samples off at Poochon Scientific.I will drop off my sample package at one of the DNA drop box locations and submit a request via the link below.
Sample Pickup Request Form
Please provide a tracking number, if applicable. If you do not have one yet, please forward the tracking information to support@poochonscientific.com once received or edit this submission.
Should be Empty:

Sample Information