Analytical Sample Submission Process at Triclinic Labs

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>>Analytical and Materials Characterization Sample Submission

If we have already provided you with a quote or pricing for Materials Characterization or Analytical Chemistry Analysis please access the sample submission options below.

If you would like a quote for routine or special chemical analysis or materials characterization click here.

Please note if your submission is after 4:30 PM EST it will be queued for analysis the FOLLOWING Business day.

Please review the Materials Characterization TERMS & CONDITIONS Document by clicking here before submitting samples

There are two ways to submit chemical samples to Triclinic Labs for routine or special characterization.

	PDF Sample Submission Form
	Word Sample Submission Form
	Shipping Label
	Form 222 Request (DEA Sched II)

1. Fill out the ONLINE Form below and press "Submit" - Upon successfully submitting this form, you will be redirected to our home page. Shortly thereafter, you will receive an email message confirming our receipt of your electronic Sample Form, along with a copy of the completed form for your own records and a shipping label. Please print the forms you receive and send them with your sample(s). Please enable cookies or scripts in order to use this feature.

2. PRINT the sample submission FORMs below, fill them in manually, and send them with your sample(s).

	1. Print out Sample Submission FORM(s) and 222 (If necessary)
	2. Print out Shipping Label
	3. Include MSDS
	4. Ship samples with Form & MSDS

Sample Submission


	ONLINE Analytical and Materials Characterization Sample Submission
	Salutation
	First Name*
	Last Name*
	Institution*
	Title
	Address 1*
	Address 2
	City*
	State*
	Province
	Zip Code*
	Country*
	Email*
	Confirm Email*
	Phone Number*
	Extension
	Fax
	I have read and agreed to the Terms & Conditions* Yes
	My billing information and address is the same as above* Yes No


	Billing Address (If Different Than Above)
	Salutation
	First Name
	Last Name
	Title
	Institution
	Address 1
	City
	State
	Province
	Zip Code
	Country
	Email
	Phone
	Fax


	Payment Info No work will be accepted without a valid PO
	Purchase Order Number*


Sample #1 Please fill in sample details below:
Sample ID*	Material Name (Include MSDS)	Light Sensitive* true false
Storage Conditions*	Analysis Requested*
Sample Amount (mg)*	Controlled Substance* Yes No


Sample #2
Sample ID	Material Name (Include MSDS)	Light Sensitive true false
Storage Conditions	Analysis Requested
Sample Amount (mg)	Controlled Substance Yes No


Sample #3
Sample ID	Material Name (Include MSDS)	Light Sensitive true false
Storage Conditions	Analysis Requested
Sample Amount (mg)	Controlled Substance Yes No


Sample #4
Sample ID	Material Name (Include MSDS)	Light Sensitive true false
Storage Conditions	Analysis Requested
Sample Amount (mg)	Controlled Substance Yes No


Sample #5
Sample ID	Material Name (Include MSDS)	Light Sensitive true false
Storage Conditions	Analysis Requested
Sample Amount (mg)	Controlled Substance Yes No


	Verification
	Add me to your mailing list* YES NO I'M ALREADY ON IT
	Anti-SPAM Verification: What is 2+7?*


	Options
	Litigation Related Analysis? YES (Additional Charges May Apply) NO
	Service Level* Standard (5-10 Business Days - Varies by Service) Rush (2-5 Business Days - XRPD, DSC, TGA, RAMAN, FT-IR, Microscopy - Varies by Service) Overnight (XRPD, DSC, TGA, RAMAN, FT-IR, Microscopy - CALL TO CONFIRM AVAIL)
	Submission Date/Time* Month Day Year Hour Minute : AM/PM
	Report Delivery* Email report only Email report with raw data Mail report only Fax report only Fax report with raw data
	Interpret Data? YES NO If "NO" only data will be provided.
	Also email the report to:
	Promotional Code
	Return Samples? NO YES ($50 Fee Applies)
	Special Instructions

ONLINE Analytical and Materials Characterization Sample Submission

Billing Address (If Different Than Above)

Payment Info

Options

Sample #1

Sample #2

Sample #3

Sample #4

Sample #5

Verification