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Proficiency Solutions Request Form

Microbiologics offers Proficiency Solutions to laboratories in need of preserving environmental isolates.

All fields are required except where noted



Contact Information:

First Name

Last Name

Job Title

Company

City

State/Province

Country

Email

What type of PT sample(s) do you need? Please select all that apply.

Qualitative single strain

Qualitative mixed culture

Quantitative single strain

Molecular inactivated control

Molecular synthetic control

Molecular genomic extract

Fecal parasite suspension

Microscopy slides

Other

How many PT events do you conduct per year?

How many PT samples are needed per event?

How many different strains will be needed per event?

Microbiologics offers our own bank of reference strains for use in proficiency samples at no additional cost to our customers. If a requested strain is not currently available in our repository, we are able to add new strains to our offering as needed. In these cases, the basic costs of acquiring any new reference strains would be billed to the requester. Please note, if ATCC® strains are requested, you will be required to sign the ATCC® Proficiency Standard® Program End User Agreement.

 

From where do you want your PT sample materials sourced? Please select all that apply.

ATCC

I will submit my own strains

Other culture collection (e.g. NCTC, CDC, NCIMB)

No, white labels with black print is good
Yes

If applicable, please specify any additional requests for your PT samples.



Microbiologics does not perform validations or shelf-life testing on proficiency testing samples and OEM orders. All validations of these products are the responsibility of the laboratory receiving these materials.

I acknowledge that all validations and/or shelf-life testing of the proficiency testing samples produced by Microbiologics are the responsibility of the laboratory receiving these materials.