Eppendorf Customized Solutions Request Form

With the aid of a checklist you are asked to define some basic specifications of your customized solution. Your specifications will help us to define the next steps to your customized solution in cooperation with you.

1/1
Volume (may be more than one)*
0.2 ml
0.5 ml
1.5 ml
2.0 ml
Other
 
Color*
colorless
colored
 
PURITY*
Eppendorf quality
PCR-clean
DNA and RNase free
Biopur
LoBind
Low Retention
Other
 
If other, explain your needs
 
System: which instrument or kit will the tubes be used for?
 
Special requirements as color, material, shape, IvD conformity, others?
 
Quantity?
 
Specific request for timeline, prices, others?
 
Salutation*
 
Title
 
Job Title
 
First Name*
 
Last Name*
 
E-mail*
 
Telephone
 
Telefax
 
Company / University*
 
Department
 
Division / Institute
 
Building
 
Room / Mailstop
 
Street*
 
 
 
City*
 
Postal Code*
 
State*
 
Country*
 
(Fields marked with * must be completed)
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