First Name *
Last Name *
SSW Contact * ---Mr. Ivan BarkerMs. Baian AlmusnedDr. Mark BiesingerMs. Heather BloomfieldDr. Vahid DehnaviDr. Jonas HedbergDr. Jeffrey HendersonDr. Carolyn Hill-SvehlaMr. Brad KobeDr. Heng-Yong NieDr. Sridhar RamamurthyMs. Becky SarazenDr. Thalia Standish
Company / Division *
Your Email *
Payment Type * Visa/MasterCard/American Express (processing details sent with invoice)P.O.Standing P.O.Other (please communicate directly with SSW)
Your Purchase Order Number
Turnaround Requested * Normal5 Day3 Day1 Day
Normal (Results generally within 10-15 business days of sample receipt) 5 Day - 25% Surcharge (Minimum verbal report within 5 business days of sample receipt) 3 Day - 50% Surcharge (Minimum verbal report within 3 business days of sample receipt) 1 Day - 100% Surcharge Minimum verbal report within 1 business day of sample receipt)
Description of Samples/Quantity/Analysis Details *
Return Samples After Analysis * NoYes (return shipping charges are not included in quotation and will be added to our final invoice)Yes (collect - please communicate courier account #) (N.B. samples will be disposed of 60 days after analysis unless otherwise advised)
Materials Specific Regulatory Requirements RadioactiveBio-hazardousToxicDangerous goods (MSDS datasheet required for all applicable substances)
Description Click here for Sample Submission and Return Guidelines Samples and area(s) of analysis should be clearly marked and labeled. International shipments should be valued at $1.00 USD. Collect shipments will be accepted, however any customs/brokerage/courier charges will be billed back to the client.
Shipping Address (Street address required for courier) *
Invoicing address (same as shipping address)
Invoicing Address
Telephone Number *
Telephone Number (Alternative)
Facsimile Number
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