Analysis Request

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Analysis Request

Principal investigator (PI)

PI Name

Last name
First name

PI Email
Telephone

Project Coordinator

Project name
Project start date YYYY-MM-DD
Coordinator email
University / Business
Work phone
Cel
Project address City Province Postal Code Country

Samples

Sample 1 (type)
Sample 2 (type)
Sample 3 (type)

If saliva, indicate method of collection

Indicate # of tubes per sample type *

	Échantillon 1	Échantillon 2	Échantillon 3
Alpha-amylase *previously run in singlet now run in duplicate, unless otherwise requested.
Androstenedione
Cortisol
CRP
DHEA
DHEAs
Estradiol
Estriol
Progestérone
Testostérone
Secretory Iga

treatment after analysis *

If there are other analyses that you require, please inform us in the comments box below.

Please indicate whether you will be bringing the samples or shipping them to the analysis and conservation laboratory. If the samples are to be shipped please make sure to follow the instructions on the web site http://www.humanstress.ca/Documents/pdf/SalivaLab/Sample{a4a662e1249520a94f8ce7e773ca0acfdaddb5b0f39745467b170a3329777f56}20shipping{a4a662e1249520a94f8ce7e773ca0acfdaddb5b0f39745467b170a3329777f56}20instruction.pdf

If shipping please also include courier name and account #.

If you will be bringing the samples to the lab in person, first contact the lab to arrange a date and time so that the samples can be handed over efficiently.

Comments or instructions

Sample delivery

One this form has been submitted you will receive a quotation for the analysis requested. Please read the conditions on the form and then sign and return it. Only when a signed agreement has been received will the sample be analyzed.