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Analytical Services Submission Form
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We have decided to keep it simple, so we can provide the level of service and turnaround time you require. We are currently offering the most common experiments without detailed interpretation HPLC Purity only provides UV purity data and does not confirm the identity of the compound.
Please complete this form, print the confirmation page and include with your sample.
Name (*)
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Company (*)
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Email (*)
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Phone (*)
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Fax
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Purchase Order #
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Date Needed
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Sample ID(s) (*)
Required Field
Multiple sample IDs can be included on the same submission as long as all the information below is the same.
Controlled Substance (*)
No
Yes
Required Field
If yes, DEA Registration Number
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Send Analytical Results via (*)
Email PDF file
Email FID file (only applies to NMR results, $5 discount if only option selected) Download software
here
or
here
Fax
Mail
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Analytical Services (*)
Proton NMR
13
C NMR
HPLC Purity
Karl Fischer
Karl Fischer with duplicate run (additional sample required)
Optical Rotation
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See pricing and minimum sample quantities.
Service Level (*)
Same-Day (Not available for all services. Sample must be received by 11 am)
2-3 Business Days
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GLP Required (*)
No
Yes (additional fees apply)
Required Field
NMR Solvent (*)
Please Select...
Not Applicable
CDCl3
D2O (+$5)
Acetone-d6 (+$5)
Methanol-d4 (+$5)
Toluene-d8 (+$5)
DMSO-d6 (+$5)
CD3CN (+$5)
CD2Cl2 (+$10)
Required Field
Use the CTRL key to select multiple solvents. Each solvent requires a separate run and charge.
Return NMR Sample (with solvent in sealed ampoule) (*)
No
Yes ($25 charge plus actual return shipping cost)
Required Field
Hazardous (*)
No
Yes (please specify below)
Required Field
No Radioactive and/or Bio-Hazardous Samples
Hazardous Properties
Toxic
Flammable
Carcinogen
Skin Irritant
Explosive
Other (please specify in comments)
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SpecialHandling
Store in -30C Freezer
Store in Refrigerator
Air Sensitive
Light Sensitive
Stench
Acid Sensitive
Decompose in Solution
Other (please specify in comments)
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Comments
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Enter the Text Below
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Please print the confirmation page after submitting and include with your sample.
By accepting this analytical services request, I agree to Chemtos’
Terms & Conditions
, unless otherwise agreed upon in writing.