Custom Request

Please fill in the following fields as best as possible. After filling out the form click the ‘Submit’ button at the bottom of this page. Please allow up to 2 business days four our team to review your request and respond accordingly.

Date of request

Title

First name *

Last name *

Job title

Company/Institute *

Department

Address line 1 *

Address line 2

City *

State

Post code

Country *

Telephone

Fax

E-mail *

Application

Please briefly describe the application *

Specifications

Glass Type

Other Glass Type

Glass Format

Other Glass Format

Glass Dimensions:

Length (mm)

Width (mm)

Diameter (mm)

Thickness (mm)

Other thickness in mm (with required tolerance)

Please note: not all glass types are available in all the thicknesses listed.

Describe critical areas:

Critical Dimension

Edge finish required

Other edge finishing

Other corner finishing

Glass coating required

Other glass coating

Please give specific details of any additional processing steps, such as drilling (round or rectangular holes). Creation of caverns or channels:

Additional Processing

Barcode Option

Other Barcode Option

Sequenced Barcode

Not required

Yes:

Sequence required

Barcode color

Please specify size and location:

Barcode position

Logo

Yes

If Yes, please specify logo type, size and location:

Logo color

Well patterns printing with permanent hydrophobic ink

Please give dimensions and locations of the wells required:

Detailed specification for optical coating

Please note! We have a minimum order value of EUR 300 / USD 300.

Number of pieces required *

Annual Usage

Other Comments

Send me a copy

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Customized Solutions
Custom Request
Customized Solutions

Exhibitions & Events

10.

March

Exhibition Molecular Med Tri-Con, San Francisco, CA, USA, 03-10 to 03-15-2019

06.

May

Exhibition Molecular Diagnostics Europe, Lisbon, Portugal, 05-06 to 05-09-2019

More Exhibitions