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SkopBio Laboratories
ANALYSIS REQUEST FORM
COMPANY INFORMATION
COMPANY NAME
ADDRESS/BILLING ADDRESS
PHONE/FAX
E-MAIL
CONTACT PERSON
PRODUCT SAMPLES AND ANALYSIS INFORMATIONS
*SAMPLE
NO
SAMPLE
NAME/KIND/BATCH
NO
*PACKAGE
AMOUNT
PRODUCTION/BEST
BEFORE DATE/
BATCH NO
*SAMPLE
DELIVERY
CONDITION
REQUESTED
ANALYSIS
*SAMPLE ARRIVAL DATE:
*SAMPLE ARRIVAL METHOD: DIRECT [ ] CARGO [ ]
POST [ ]
*REPORT DATE:
RESULT OF ANALYSIS SUBMISSION: DIRECT [ ]
CARGO [ ] E-MAIL [ ] FAX [ ]
WILL YOU SEND A SPECIAL REPORT FORMAT? YES[ ] if yes, we kindly request you to send us the model
report with wet signature and your company sealed. NO [ ]
*SAMPLE CONDITION: ACCEPTED [ ]
REJECTED[ ]
ANALYSIS PRICE:
*Marked fields will be filled by our laboratory. We kindly request you to fill this form for every analysis request and
deliver to our laboratory with desired communication method.
Please contact our company for price offers of the mentioned analysis.The customer who fills and signs this form will be
deemed to have accepted the working conditions of the laboratory and this form is assumed as a contract with between the
laboratory and the customer.
In case of an objection about the samples or the reports, the laboratory must be contacted within 5 (five) days, clear
information on the objection request must be transmitted and the laboratories objection confirmation or denial must be
waited.
We kindly request the analysis mentioned above for …… (number) of product samples delivered.
SAMPLE
DELIVERED
BY 5 (beş) gün içerisinde laboratuvar ile görüşülmelidir
SAMPLE
RECEIVED
BY
Herhangi bir
itiraz durumunda
en fazla
ve itiraz
talebi hakkında
açık
bilgi verilerek laboratuvarın itiraz onayı ya da reddi beklenmelidir.
Please fill the form and fax to number +90 (216) 324 85 87 or scan the form and e-mail to:
[email protected]
SkopBio Laboratories Limited Company, Altinsehir Mah. Tavukcuyolu Cad. Okyanus Sok. No:3
Umraniye, Istanbul, Turkiye
FM404_02 R0302/11/2015
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