Sample Preparation service

Questionnaire to be filled by customer


To avoid unnecessary delays, please complete and send this form PRIOR shipping your samples!

2. Specimen safety regulation –filling these fields is mandatory


Please note in case one of these checkboxes is ticked with Yes, further details for internal verification prior shipping the sample are required. Please understand due to our safety regulations we can’t accept samples without detailed information if potentially harmful and/or hazardous

°C

3. Current mechanical and/or chemical specimen preparation (by customer)

4.Detailed description of desired preparation

Files must be less than 5 MB. Allowed file types: gif jpg jpeg png.

5.Objective of observation

6.Imaging done by

7.To prioritize the sample preparation effort may we ask to select one of following

8.Customer agrees that JH Technologies may use the preparation results (images,Applications,…) in documentation.

We/I confirm the completeness and correctness of the above-mentioned details.

Please enter the date in (MM/DD/YYYY) format