Flow Cytometry Service: Quote Request Form

CONTACT INFORMATION

Name*

First Name* Last Name*

Institution:*

Country:*

E-mail:*

Phone Number:*

SERVICE INFORMATION

Sample Information

Sample Species:*

If Other, which species are you studying?

Sample Origin:*

If Other, from where did your sample originate?

Will your sample require red blood cell lysis?*

Yes

No

Sample Type*

Sample Type (RayPlex Bead Arrays) *

Cells

Exosomes

Sample Number:*

Will all samples be sent at one time?*

Yes

No

If No, how many samples will be sent per batch?

If No, how often will a batch be sent to RayBiotech?

If No, for how long will batches be sent?

If No, are you interested in a long-term service contract?

Number of cells (or exosomes) per sample:*

When do you want to send samples for the flow cytometry service?*

Do you need the service expedited?*

Yes

No

If Yes, how soon after the samples are received at RayBiotech, do you need your data?

If Yes, how soon after the samples are received at RayBiotech, do you need your data? (Before this service can start, RayBiotech will require payment information, samples, and a completed sample service form)

Gating Information

Which subpopulation(s) do you want to detect? (e.g., Th1 T cells, mesenchymal stem cells)*

Do you know which markers should be stained to enable the measurement of this subpopulation?*

Yes

No

If Yes, which markers should be stained?

If Yes, how many total markers will be used for this analysis? If cells will be analyzed, be sure to count the marker for viability.

If Yes, are any of these markers intracellular proteins?

Yes

No

If Yes, list the intracellular proteins that will be stained:

If Yes, how do you want the data gated? (e.g., live/CD3+/CD4+)

Optional Information

In 4 sentences or less, tell us the overall objective of your study. This can help us to provide the best quality analysis for you.

Additional Comments:

Name

This field is for validation purposes and should be left unchanged.

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Flow Cytometry Service: Quote Request Form