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Microorganism Request Form

Need a strain that we don't offer? Send us a request to add the strain to our catalog using the form below. Our team follows up with all requests, typically by email, so watch for a response from us soon.

Microbiologics® Lyophilized Microorganism Request Form

Microorganism Request Form


Please use this form to request a microorganism strain or enumerated microorganism preparation that is currently not available from Microbiologics®. The information provided below will help us evaluate your request.


First Name*

Last Name*

Job Title

Company*

Address Line 1

Address Line 2

City

State/Province

Zip/Postal Code

Country

Phone*

Email*

Microorganism Name*

Reference # or Culture Collection

Select your packaging preference

If Other packaging is preferred, please describe

If Epower™ is selected above, specify the desired concentration
What is your intended application for this strain?
Is the specific application for this microorganism preparation for quality control?
Is the application mandated by a regulatory agency?
If yes, specify the regulatory agency and the regulatory document
How many times per month will the new microorganism preparation be used?

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