Custom QC Quote Form

Name(Required)

Company Name(Required)

Email(Required)

Customer ID(Required)

Phone Number(Required)

Job Function

New Order or Reorder(Required)

New Order

Reorder

This field is hidden when viewing the form

New Order Section Break

Analytes & Concentrations

If you require a blank matrix (e.g., urine, blood, serum, sMX serum, etc.) without any analytes, please leave the Analytes fields blank. Be sure to complete the Matrix, Form, Vial Fill Size, Vial Size Units, and Total Number of Vials fields. Providing this information will allow us to accurately process custom blank matrix and custom fill size requests.

Matrix(Required)

Form(Required)

Vial Fill Size(Required)

Our minimum order quantity is 50 mL.

Vial Size Units(Required)

Total # of Vials(Required)

Enter and select analytes needed for your custom control, and add concentration and notes:

Analyte 1

Level 1

Level 2

Level 3

Level 4

Level 5

Unit of Measure

Did you find the correct Analyte in the list above?(Required)

Yes.

No, I would like to manually enter the Analytes.

Some Analytes might not be listed in the dropdown above. Select No, if you would like to add your own Analytes.

Analyte 1

Level 1

Level 2

Level 3

Level 4

Level 5

Unit of Measure

Would you like a matrix sample for screening?(Required)

Yes, I want a matrix sample included.

No, I will accept the risk of potential interference.

Screens for interference before manufacturing. Required for endogenous analytes.
Adds 1-2 weeks to lead time, may increase cost.

Would you like this custom control verified by a third-party testing lab?(Required)

Yes, I want my custom control sent for external testing.

No, I do not want external testing.

Confirms concentration with a 3rd party lab (Single-run test)
Adds 3-4 weeks, subject to additional cost per analyte. Inquire for additional information.

Would you like a product validation sample prior to receiving your order?(Required)

Yes, I want a sample sent prior to shipping the full order.

No, I want the order shipped immediately after manufacturing.

Receive 1 vial per level for approval before full shipment at no additional charge.
Adds 1-3 days to receive full order, but ensures satisfaction.

Do you have your specifications handy? Save time by attaching them here.

Drop files here or

Accepted file types: pdf, csv, xlsx, , Max. file size: 50 MB, Max. files: 5.

Comments or Questions

This field is hidden when viewing the form

Reorder Section Break

Lot Number(Required)

Invoice Number / PO(Required)

Quote Number(Required)

Do you have your specifications handy? Save time by attaching them here.

Drop files here or

Accepted file types: pdf, csv, xlsx, , Max. file size: 50 MB, Max. files: 5.

Enter Changes Here

Vial specifications:
Need a specific vial or label? If you don’t have a preference, the Control Freaks can choose for you.

This field is hidden when viewing the form

Vial Type

This field is hidden when viewing the form

Label 1 Color

This field is hidden when viewing the form

Label 2 Color

This field is hidden when viewing the form

Label 3 Color

This field is hidden when viewing the form

Label 4 Color

This field is hidden when viewing the form

Label 5 Color

Fill size and quantity:
Please note that our minimum order is 50mL per level.

This field is hidden when viewing the form

Time Frame