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Inquiry Forms – prefilled form Collections & Panels

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Name
First Name Last Name
E-Mail*

Your E-Mail address
Company
Your Company

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Requested Services
Requested services*
- Select All
- Recruitment of donors/procurement of samples
- Study plan
- IRB/IEC
- Submission of documents and contact with authorities
- Project management
- Laboratory analysis
- Data management
- Bioanalytical evaluation and report
Define services you like to utilise, e.g. special shipping requirements, support for (parts of) your study
Further information
Please give us details about the services you need, e.g. the tested device for the validation study
Additional services
Additional services
Please define additional services you wish to utilise, e.g. special requirements for shipping, additional questions the donors should answer (e.g. Do you do sports?) If necessary we will contact you for further information or details
No special requirements*
- No special requirements

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Sample requirements
Define quantity, volume and matrix
Remark: If you want to order matched sets please use the „Add +“ button at the end of this part.
Sets*
- Matched sets
- No matched sets
Please define whether you need matched sets of samples. If you choose matched sets you first define one part of the set. At the end of this part you need to choose „Add +“ to define the next part of the set.
Quantity*
- Amount of samples
- Total quantity
Please choose „Amount of samples“ if you need a specific amount of samples. Please choose „Total quantity“ if you need a specific quantity independent from the amount of samples.
Amount of samples*
Amount of samples*
Please fill in the amount of samples you need, e.g. > 200, min. 100, 150
Quantity per sample*
Quantity per sample*
Please fill in a quantity, e.g. 5-10, > 10, 1
Quantity per sample*
Please define the needed quantity, e.g. 500, min 350 and choose a unit, ml, g, mg or l
Quantity per sample*
Unit*
Please choose a unit
Quantity per aliquot*
Quantity per aliquot*
- Individual aliquots
- Pool
- No special requirements
Quantity per aliquot*
Please define a quantity per aliquot, e.g. 10 ml
Amount of samples per donor*
Amount of samples per donor*
Please fill in a number. If you need single donations please fill in a 1
Amount of samples per donor
- No special requirements
Consecutive donations*
- Yes
- No
Time between donations*
Please fill in a number
Time between donations*
Please define a time unit, e.g. weeks, trimester, hours
Time between donations
- No special requirements
Matrix*
- Serum off-the-clot
- K2EDTA plasma
- K3EDTA plasma
- Whole blood
- Li-heparin plasma
- Sodium citrate plasma
- Na-heparin plasma
- Urine
- Faeces
- Vaginal swab
- Vaginal-rectal swab
- Saliva
- CPT (Cellular Preparation Tube)
- Recovered plasma (CPD plasma)
- Other
Please choose the matrices that are acceptable for you. Samples will be one of the chosen matrices, e.g. serum off-the-clot or K3EDTA plasma. Matched sets will be handled separatly.
Description*
Please describe the matrix you wish to have
Matched sets*

Please use this button if you want to have matched sets

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Donor Requirements
Define special requirements for donors, e.g. gender ratio, ethnical group
Gender*
- Male
- Female
- Gender ratio [%]
- Mixed gender
Female*
Please enter a number from 1 to 100.
Male*
Age of donors*
Age of donors*
Please define an age [years], e.g. > 50, 20-30
Age of donors
- No special requirements
Ethnical Group*
- European/Caucasian
- Other
- No special requirements
Ethnical group*
Please define an ethnical group, e.g. African, American
Blood group*
- A
- B
- AB
- 0
- No special requirements
Please choose a blood group
Rhesus factor
- +
- -
Please choose a blood group
Fasting
- Yes
- No
- No special requirements
Time since the last food consumption*
Please define the time that should have passed since the last food consumption, e.g. > 8 hours, < 1 hour

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Sample Handling
Define requirements for sample handling, e.g. storage temperature, labelling, filling
Storage temperature (post-processing)*
Storage temperature (post-processing)*
- 2-8 °C
- < -70°C
- Other
Please choose „Other“ if you want to define specific storage periods, e.g. 2 h at 2-8 °C, then min. 24 h at < -18 °C
Specific storage periods*
For defining of storage periods please give us details about time and temperature, e.g. 2 h at 2-8 °C
Storage temperature (post-processing)
- No special requirements
Processing (centrifugation, temperature etc.)*
- Special requirements
- No special requirements
Special requirements*
Special requirements*
Please define your requirements for e.g. centrifugation
Filtration and sterility*
- 0,22 µm filter
- 0,4 µm filter
- Sterile
- Non sterile
- No special requirements
Filling Container
- Specific manufacturer
- No special requirements
Manufacturer*
Please define a manufacturer
Article number*
Please define an article number
Labelling*
- Client‘s label
- Neutral label
- Other
- No special requirements
Special labelling*

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Diagnostic Information
Define a diagnosis text or ICD-Code, e.g. self-reported healthy, M05.-
Diagnostic information*
- ICD-GM-Code
- Diagnosis text
Diagnostic information
- No special requirements
ICD-Code or diagnosis text*
Please define an ICD-Code (German Modification) or a diagnosis text, e.g. E05.0G, diabetes mellitus II Please define only one diagnosis. If you wish to have more diagnosis‘ you can use the And +/Or + buttons below. If you want material from normal donors please choose „self-reported healthy“
And +

Please choose „And +“ if you want a sample from a donor which has several diagnosis‘, e.g. pregnant and Hashimotos thyroiditis
Or +

Please choose „Or +“ if you want a sample from a donor which has either diagnosis, e.g. Graves disease or Hashimotos thyroiditis
Information on Medication
Define required medications
Medication*
Medication*
Please define a medication. Please define only one medication. If you wish to have more medications you can use the And +/Or + buttons below. You can use active agents as well as commercial names or choose „no medication“.
Medication
- No special requirements
Medication*
- Define a dosis
- therapy period etc.
Medication
- No special requirements
Medication*
Please define a specific dosis, period of therapy or other special requirements concerning the medication above.
And +

Please choose „And +“ if you want a sample from a donor which takes several medications, e.g. L-thyroxine and folic acid
Or +

Please choose „Or +“ if you want a sample from a donor which takes either medication, e.g. RoActemra or Enbrel

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Laboratory Parameters
Define required measurements, e.g. parameters, ranges, test systems.
Parameter*
Parameter*
Please define a laboratory parameter which should be measured. Please define only one parameter. If you wish to have more parameters measured you can use the And +/Or + buttons below.
Parameter
- No special requirements
Range*
- Define a range
- No special requirements
Range*
Please define a measured value or range, e.g. > 50, 30-40, positive
Range*
Please define a unit of measurement, e.g. U/ml. If you choose a measured value without unit (e.g. positive), please fill in with /
Test method*
- Define a test method/-kit or -system
- No special requirements
Test method*
Please define a test method, test kit or analytical system you want your sample to be measured in, e.g. cobas from Roche. You can also make more general statements, e.g. FDA approved kit, CE marked system
Add +
Please choose „And +“ if you want a sample which is measured in several parameters, e.g. TSH and aTPO
Range*
- Define a range
- No special requirements
Please be aware: Your sample could also be negative for the measured parameter
Range*
Please define a measured value or range, e.g. > 50, 30-40, positive
Range*
Please define a unit of measurement, e.g. U/ml. If you choose a measured value without unit (e.g. positive), please fill in with /
Test method*
- Define a test method/-kit or -system
- No special requirements
Test method*
Please define a test method, test kit or analytical system you want your sample to be measured in, e.g. cobas from Roche. You can also make more general statements, e.g. FDA approved kit, CE marked system
Add +
Please choose „And +“ if you want a sample which is measured in several parameters, e.g. TSH and aTPO
Range*
- Define a range
- No special requirements
Please be aware: Your sample could also be negative for the measured parameter
Range*
Please define a measured value or range, e.g. > 50, 30-40, positive
Range*
Please define a unit of measurement, e.g. U/ml. If you choose a measured value without unit (e.g. positive), please fill in with /
Test method*
- Define a test method/-kit or -system
- No special requirements
Test method*
Please define a test method, test kit or analytical system you want your sample to be measured in, e.g. cobas from Roche. You can also make more general statements, e.g. FDA approved kit, CE marked system
Add +
Please choose „And +“ if you want a sample which is measured in several parameters, e.g. TSH and aTPO
Range*
- Define a range
- No special requirements
Please be aware: Your sample could also be negative for the measured parameter
Range*
Please define a measured value or range, e.g. > 50, 30-40, positive
Range*
Please define a unit of measurement, e.g. U/ml. If you choose a measured value without unit (e.g. positive), please fill in with /
Test method*
- Define a test method/-kit or -system
- No special requirements
Test method*
Please define a test method, test kit or analytical system you want your sample to be measured in, e.g. cobas from Roche. You can also make more general statements, e.g. FDA approved kit, CE marked system
Or +
Please choose „And +“ if you want a sample which is measured in several parameters, e.g. TSH and aTPO
Range*
- Define a range
- No special requirements
Please be aware: Your sample could also be negative for the measured parameter
Range*
Please define a measured value or range, e.g. > 50, 30-40, positive
Range*
Please define a unit of measurement, e.g. U/ml. If you choose a measured value without unit (e.g. positive), please fill in with /
Test method*
- Define a test method/-kit or -system
- No special requirements
Test method*
Please define a test method, test kit or analytical system you want your sample to be measured in, e.g. cobas from Roche. You can also make more general statements, e.g. FDA approved kit, CE marked system
Or +
Please choose „And +“ if you want a sample which is measured in several parameters, e.g. TSH and aTPO
Range*
- Define a range
- No special requirements
Please be aware: Your sample could also be negative for the measured parameter
Range*
Please define a measured value or range, e.g. > 50, 30-40, positive
Range*
Please define a unit of measurement, e.g. U/ml. If you choose a measured value without unit (e.g. positive), please fill in with /
Test Method*
- Define a test method/-kit or -system
- No special requirements
Test method*
Please define a test method, test kit or analytical system you want your sample to be measured in, e.g. cobas from Roche. You can also make more general statements, e.g. FDA approved kit, CE marked system
Or +
Please choose „And +“ if you want a sample which is measured in several parameters, e.g. TSH and aTPO
Range*
- Define a range
- No special requirements
Please be aware: Your sample could also be negative for the measured parameter
Range*
Please define a measured value or range, e.g. > 50, 30-40, positive
Range*
Please define a unit of measurement, e.g. U/ml. If you choose a measured value without unit (e.g. positive), please fill in with /
Test Method*
- Define a test method/-kit or -system
- No special requirements
Test method*
Please define a test method, test kit or analytical system you want your sample to be measured in, e.g. cobas from Roche. You can also make more general statements, e.g. FDA approved kit, CE marked system

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Testing for Infectious Diseases
Testing*
- in.vent Standard
- No testing
- Custom testing
- As available
in.vent Standard: antibody testing (single donor) for HIV 1/2-Ab, HCV-Ab and HBsAg
Testing*
Please define infectious diseases you want to have tested, e.g. Treponema pallidum, HTLV-1
Testing*
- Antibody testing (single donor)
- PCR testing (pool)
- Other
Testing*
Please define the way you want the samples to be tested, e.g. single donor or pool, PCR or antibody testing

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You have a requirement you couldn‘t find in the inquiry form? Please use the box below to describe anything you wish to add.
Description
Consent*
You agree that your information will be used to process your request. Further information and revocation instructions can be found in the privacy policy. A copy of your message will be sent to your e-mail address.

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

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LOCATION

Neuendorfstraße 17
D-16761 Hennigsdorf bei Berlin

Zentrale: +49 (0) 3302 55199-0
FAX: +49 (0) 3302 55199-999

E-mail: info@inventdiagnostica.de

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