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Service Order & Sample Submission Form

HomeService Order & Sample Submission Form

AssayGate, Inc. is pleased to offer testing services for protein biomarkers. Please complete the following information and return this form with your samples. Thank you!

Sample Shipping, Data Delivery And Billing Information

SHIPPING CONTACT

Name

Report Contact

Name

Billing Contact

Billing Address

Sample Information

Species
Matrix
Storage Tube

Volume & Sample #

Has Sample Manifest Been Submitted To Assaygate (orders@assaygate.com) By Email?

Service Order & Sample Submission Guidelines

The Service Order & Sample Submission Form must be completed to ensure the proper and expeditious processing of your samples. A printed copy of the completed form should be included with the sample shipment. Please provide the quote number, study number and PO number in the box at the top of the form which is a required field. Orders received without P.O. or Credit Card information will not be processed. If you are a new customer, please attach a copy of the purchase order to your sample submission form so we can ensure the billing information is correct. Credit card information is not retained. You must provide credit card information by phone for any orders you are charging on a credit card each time an order is placed.

1. SAMPLE VOLUME REQUIREMENTS:
Volume requirements for your samples can be found in the AssayGate quote.

2. SAMPLE PACKAGING:
1). Make sure samples are in a tightly closed “LEAK-PROOF” tubes (e.g. RTT) or “LEAK- PROOF” aliquot tubes made of polypropylene.
2). Store a variety of vials and tubes with Storage Boxes, for use in ultra-low temperature freezers.
3). Pack samples with sufficient dry ice. Make sure your contents are frozen when you are ready to pack them.
4). Use an EPS foam container for its insulating properties, and place it inside a sturdy, corrugated cardboard box.
As with storage containers, DO NOT seal your dry ice box airtight—the vapor needs to be able to escape or your package could explode. Go lightly with the packing tape.

3. SAMPLE SHIPPING AND DATA DELIVERY INFORMATION:
Include the company name, telephone number, contact name and email address to where data should be sent and a contact name and email address to where sample inquiries should be addressed. Samples should be shipped on dry ice Monday thru Thursday via FedEx priority or other overnight delivery services to:

James Lu
AssayGate, Inc.
9607 Doctor Perry Road, Suite 101
Ijamsville, MD 21754

Phone 301-874-0988
Email orders@assaygate.com
Fax 301-560-8288

Sample shipment date must be notified to AssayGate by email in advance or on the day when samples are shipped out

5. SAMPLE MANIFEST:
Sample manifest should contain unique sample accession numbers. Please identify your samples via electronic sample manifest, preferably in Excel format, and e-mail to orders@assaygate.com along with your sample submission form. When your samples are delivered, we verify the number of samples and labeled sample identifications against the submitted Sample Manifest. If there is a discrepancy, we will contact you. Samples will not be processed until all samples are properly identified.

4. SAMPLE INFORMATION:
Indicate the species, sample type and, if plasma, the anticoagulant by checking the appropriate box, sample volume per vial, aliquot # per sample, storage tube size.

Notes

1. This service order cannot be canceled once your submission form is submitted.
2. Sample leftovers will be kept in our freezers for 6 months and then destroyed unless otherwise requested by your email.
3. WE DO NOT SERVICE INFECTIOUS SAMPLES (BIOSAFETY LEVEL 3 & 4)!

MM slash DD slash YYYY
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FOR ASSAYGATE STAFF USE ONLY

Shipping Conditions
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Address

9607 Doctor Perry Road, Suite 103, Ijamsville, MD 21754.

Email

info@assaygate.com

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(301)874-0988

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Copyright © 2025. AssayGate - All Right Reserved.
  • Home
  • Services
    • Luminex Multiplex Assays
    • High-Precision MSD-ECL Assays
    • Conventional ELISAs
    • Ultra-Sensitive Simoa Assays
    • Endotoxin/LPS Measurement
    • High-Throughput Olink Multiplex Assays
    • Custom Assay Development
    • Discriminatory Biomarker Analysis
  • Products
    • ELISA Kits
    • Custom Immunoassay Kits
  • Orders
  • Company
    • Our Mission
    • Our Approach
    • Technology Platforms
    • Bibliography
    • Partners and Distributors
    • Careers
  • Contact us

To contact us directly:

Phone: (301)874-0988(main)
(301)874-0417(customer service)
(301)874-0977(technical support)
Fax: (301)560-8288
Email: info@assaygate.com
URL: http://www.assaygate.com
Mail: 9607 Dr. Perry Road
Suite103
Ijamsville, MD 21754
USA

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