Good Quality Service is a lasting impression! ®

Laboratory Management System!

Sample Submission Form

Customer details: Company or Business name:
Customer First name:
Customer Surname:
Contact email address:
Contact phone number:
Purchase Order number:

Purchase Order Number or a tracking number, must be submitted with the sample, at time of delivery or before!

Tests required:

Tick √ the sample type and insert number of samples and sum the numbers for Total samples submitted:

Water
Food
Swabs
Airplates
Chemical
Other
TOTAL

The integrity of the sample and its delivery to the laboratories, is at the Customer's risk!
Perishable samples such as water, swabs and meat must be transported at temperatures between 4 and 10 degrees Centrigade; and delivered to the laboratory in less than 24 hours from the time the sample is drawn/harvested.

Sampled by: Authourised by:
We agree to the Terms and Conditions of Business! Dated:

Sample testing required as below:

Water
Food
Swabs
Airplatess
Chemical
Other

Document number BST/lims/05; issue date: March 2023