Submit A Sample

Sample Type *

1. TEST DESCRIPTIONS & PRICE

Complete Test — $460.00

Complete Test Includes:

Peptide Purity & Identity — HPLC and/or Mass Spectrometry

HPLC and/or Mass Spectrometry is used to evaluate peptide identity and chemical purity. Testing provides analytical confirmation of the sample’s composition and identifies detectable impurities or related compounds.

Endotoxins

Endotoxin testing measures the presence and level of bacterial endotoxins within the submitted sample. Results provide an additional measure of sample quality and help identify potential endotoxin contamination.

Net Peptide Content

Net Peptide Content testing determines the actual quantity of peptide within the sample, accounting for components such as water, salts, and counterions. This provides a more precise measurement of the peptide content present in the submitted material.

2. CUSTOMER INFORMATION

Company / Organization Name:
Contact Person:
Phone Number:
Email Address:

License Number:

3. SAMPLE INFORMATION & TESTING SELECTION

Use additional pages if needed.

Peptide Name / ID	Complete Test — $460 Includes Purity & ID, Endotoxins & Net Peptide Content	Lot / Batch #
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes
	Yes

4. NOTES / COMMENTS

5. COMPLIANCE ATTESTATION

By signing below, you acknowledge and agree to the following terms and attest to your compliance with all applicable laws and regulations.

RESEARCH USE ONLY (RUO)

I certify that the material being submitted is for research use only and is not intended for human or veterinary diagnostic or therapeutic use, nor for any form of human consumption.

LEGAL COMPLIANCE

I certify that the purchase, possession, manufacture, use, and transfer of these materials comply with all applicable local, state, federal, and international laws and regulations.

NO MEDICAL CLAIMS

I will not make any claims, statements, or representations regarding the safety, efficacy, or intended use of these materials for medical purposes.

AGE REQUIREMENT

I confirm that I am at least 18 years of age and am legally authorized to enter into this agreement on behalf of myself or the entity I represent.

ACCURACY OF INFORMATION

I certify that all information provided in this form is true, accurate, and complete to the best of my knowledge.

INDEMNIFICATION

I agree to indemnify and hold harmless Peptides Testing Lab, its affiliates, employees, and agents from any and all claims, liabilities, damages, or expenses arising from the use or handling of the materials submitted.

TERMS ACCEPTANCE

I acknowledge that failure to comply with these terms may result in refusal of testing, voiding of results, and/or legal action.

By signing below, I confirm that I have read, understood, and agree to all the terms and conditions outlined above.

Print Name:

Title / Position:

Signature:

Date:

6. CREDIT CARD AUTHORIZATION

I authorize Peptides Testing Lab to charge my credit card for the services selected on this form.

CREDIT CARD INFORMATION

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Secure Credit Card Payment

BILLING ADDRESS

Billing Address:
City:

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PAYMENT AUTHORIZATION

I authorize Peptides Testing Lab to charge the credit card provided above for the testing services selected. I understand that all payments are non-refundable once processing has begun. I agree to pay for all charges in accordance with the terms of service.

TERMS & CONDITIONS

Authorized Signature:

Date:

Select Sample Type

1. TEST DESCRIPTIONS & PRICE

2. CUSTOMER INFORMATION

3. SAMPLE INFORMATION & TESTING SELECTION

4. NOTES / COMMENTS

5. COMPLIANCE ATTESTATION

6. CREDIT CARD AUTHORIZATION

CREDIT CARD INFORMATION

BILLING ADDRESS

TERMS & CONDITIONS

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