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Pre-packed Column Intake
Form
First Name
Last Name
Company
Street Address
Street Address Line 2
City
Region/State/Province
Postal / Zip code
Phone
Email
1. Testing Method Required
UV (standard)
Conductivity
Other - Please explain below
2. Mobile Phase or Test Component Specifications
0.1N NaCI Mobile Phase and Uracil (standard)
Other - Please explain below
3. Shipping Requirements
PBS/20% Ethanol (standard)
Other - Please explain below
4. Flow Rate/Dwell Time Specifications
5. Asymmetry Speifications
6. Additional Wash or Sanitization
7. Additional Report Requirements
Submit
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