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(888) 80-QALAB or (888) 807-2522

You will receive an invitation and instructions via email on how to access our new client portal.

Instructions for Chain of Custody Form

SAMPLES Indicate:
  • individual
  • composite
DESCRIPTION(S)/LOT(S)

Please try to limit to 30 characters. No more than 30 characters will show on your corresponding invoice.

STANDARD REPORT or CERTIFICATE OF ANALYSIS Indicate one or the other for the type of report you need.
SPECIAL INSTRUCTIONS Enter any Special Instructions for your sample(s) on the corresponding row. Examples include:
  • use [specific] method
  • shelf life test every [number] days for [number] days
  • hold sample [number] days
  • return sample after testing
  • composite sample
  • For RUSH samples, see ANALYTE, below.
ANALYTE

Select Analytes

For products and services not found, please submit a request for quotation by emailing jon@trelfalabs.com.

PURCHASE ORDER # Enter your Purchase Order number, if applicable.
ACCOUNT #

You must have an Account # to complete this form. If not, visit trelfalabs.com/new-customer to submit your company’s information. Account #s are typically assigned within 48 hours.

If you have an account with us, you will find your Account # in the upper right corner of your invoices.

AUTHORIZED BY Enter the Name of the person authorizing the submission of this form.
COMPANY Enter the name of the Company authorizing the submission of this form.
ADDRESS Enter the company’s Address authorizing the submission of this form.
EMAIL Enter the Email of the person authorizing the submission of this form.
SEND TEST RESULTS TO (IF DIFFERENT)

Enter Email address(es) of any third parties you authorize Trelfa Labs to send test results to on your behalf.

Note: We do not bill third parties on your behalf. If you plan to forward a Trelfa Labs invoice to a third party for reimbursement for specific tests, we suggest that you submit those tests on a separate Chain of Custody.

TELEPHONE Enter the Telephone number of the person authorizing the submission of this form.
DELIVERED VIA Select the means of getting the sample to the lab from the drop-down list.
PRE-PAY OPTIONS Select the Pre-pay Option from the drop-down list.
DATE Enter the Date you are submitting the form in the following format: dd/mm/yr

Further Assistance

If you need assistance downloading, completing, or sending a file, or would like to make suggestions for improving a document, contact Rebecca Hardy at rebecca@trelfalabs.com or (978) 417-2525 (cell), 9 am to 5 pm, Eastern Time.

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