Custom Peptide Inquiry Form_ Fisher Scientific by hilen


									Custom Peptide Inquiry Form
Thermo Scientific Open Biosystems Custom Peptide Service leverages our leading-edge capabilities and expertise to deliver the quality peptides you need. Whether you need small-scale crude peptides for basic applications or large-scale, highly purified peptides for quantitative applications, just fill out this form and you will receive a customized plan and quote to best fit your peptide synthesis requirements. Step 1: Fill out form below and fax in or email to Thermo Scientific Open Biosystems to be contacted by a project manager Step 2: Receive a personalized plan and quote from your Fisher Scientific Sales Representative Step 3: Order through Fisher Scientific

Customer Information Name: Email: Address (City, State and Zip): Phone Number: Organization / Department: Number of peptides you need made Do you need research grade or analytical grade peptides Scale of synthesis Purity required? Do you require any labels (e.g. biotin)? Do you require any of the following modifications? What is your required turn around time? Do you require peptide design assistance? Peptide Sequence(s) – one per line: Research <5mg >50% Yes Analytical 10mg >70% No Acetylated amino acid Methylated amino acid Branched peptide 4-6 weeks Other Yes No 20mg >80% 50mg >90% 100mg+ >95%

C-terminal amidation N-terminal acetylation Phosphorylated amino acid <2 weeks 2-4 weeks

Comments / special requirements?

Fisher Scientific Representative Name: Phone Number: Email: Fisher Account Number (if known):

Please complete this form and forward to: or fax # 1-256-704-4849

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