Advanced Analytical Testing Laboratories

Services

Sample Submission Form

SEND REPORT TO:	SEND INVOICE TO: Same as Report
Contact Name* Company* Address* City* State / Province / Region* Postal / Zip Code* Phone Number* Fax Email*	Contact Name* Company Address City State / Province / Region Postal / Zip Code* Phone Number Fax Email*

Test Article Lot Number / Serial Number / Part Number / Laboratory Number: *

Test Article Additional Description: *

Test Services Requested

Type of Test
(Name of Procedure)

1
2
3
4
5

Method to be Followed
(USP, EP, ACS, Client Protocol)

Additional Notes or Instructions
(Specification Reference)

OOS Investigation: If sample does not meet specification, do you require Advanced Analytical Testing Lab to perform Out-Of-Specification (OOS) Investigation?Yes No

Final Sample Disposition

Dispose of Sample

Hold Sample for Days

Return Sample Upon Test Completion

Advanced Analytical Laboratories will retain sample(s) in the laboratory for 30 days post report issue date then dispose of sample(s) unless other arrangements are requested.

Final report to be FAXED to client contact upon QA/QC approval of test results Original hard copy of final report to be mailed