PCRBIO sample form

Please Complete the following information so we can get the correct to you.
Remember to enter the code at the bottom before submitting to Innovative Solutions

TELL US HOW TO REACH YOU:

First Name: Last Name:

Email: Phone:

Institution/Company: Building: Room:

City: State: Zip:

Tell us more about your application and which thermocycler you are using so we can cross the systems and reagents to make sure we get the correct sample to you:

Real Time PCR: End Point: 5x cDNA Synthesis:

Thermocycler Brand: Thermocycler Model:

Current PCR /qPCR Reagent Brand: Reagent Catalog #:

Sample Checklist:

Taq Polymerase Samples (20 plus units):

PCRBIO Taq DNA Polymerase:               PCRBIO Taq Mix:
PCRBIO HS Taq DNA Polymerase:         PCRBIO HS Taq Mix:
PCRBIO Ultra Polymerase:                      PCRBIO Ultra Mix:
PCRBIO HiFi Polymerase:                       PCRBIO Classic Taq:

Ladder Samples (5 Lanes) :

PCRBIO Ladder I: PCRBIO Ladder II: PCRBIO Ladder III: PCRBIO Ladder IV:

qPCR Reagents Samples ( 10 reactions):

qPCRBio SyGreen Lo-Rox:                       qPCRBio SyGreen Hi-Rox:
qPCRBio Probe Lo-Rox:                           qPCRBio Probe Hi-Rox:
qPCRBio SyGreen One Step Lo-Rox:       qPCRBio SyGreen One Step Hi-Rox:
qPCRBio Probe One Step Lo-Rox:           qPCRBio Probe One Step Hi-Rox:
qPCRBio Probe One-Step No-Rox:          qPCRBio Probe No-Rox:
qPCRBio Genotyping Mix Lo-Rox:         qPCRBio Genotyping Mix Hi-Rox:
qPCRBio Genotyping Mix No-Rox:         qPCRBio HRM mix:

Use this space to tell us anything else about your application or to ask questions. Remember to enter the code at the bottom of the form and click the submit button to email this request directly to Innovative Solutions. Thank You!





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