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Test Code	Study Name	Protocol #	Extractions Specifications
Test Code	Study Name	Protocol #	Direct Contact	Condition	Vehicle(s)

Ship Samples To	Select the location that you will be shipping the samples to. There is site-specific information that will populate on the form.
P.O. #	Provide your Purchase Order number. This number will be listed on your invoice. The PO should reflect the quoted amount for the services you are requesting.
Quote #	Provide the quote number you received from your account representative. If you are requesting services different than what was quoted or if the quote has expired, please contact your account representative for a new quote.
Number of Test Codes	Please indicate the number of different test codes you plan to submit. This will populate the correct amount of test samples for each test code. Maximum number allowed is 10. You can find these codes on your quote or the Nelson price list on our website in the form of three alpha characters followed by three numbers, for example: ABC123.
Courier Name & Account #	Provide your preferred courier and your account number if you elect to have your samples and / or shipping container returned (extra charge).
Sponsor Information	The information you provide here will be listed on the final report of the study, and the contact will be used as the contact throughout the study.
Billing Information	This will be where the invoice will be sent for payment. If it is the same as Sponsor Information, check the “Same as Sponsor” box, and it will automatically populate the information.
Test Code / Item #	Enter the test code / item #. The test code is listed as item # on your quote.
Test Description	Provide a brief description of the testing or the test name.
# of Samples Sent	How many total samples you sent (including any extras).
# of Samples to Test	How many of the samples you sent that you would like us to use for testing purposes.
Test Individually	This will produce a separate result for each sample (affects pricing).
Test Pooled	We will pool your samples together and produce one result for all samples pooled together.
# in Each Pooled Set	Use this box to indicate the number of samples you would like tested in each pooled set. (Example: 6 total samples, tested in two sets of 3 – enter 3 in this box.)
CSS#	Customer Specification Sheet (CSS) is an approval form that indicates specific testing details that supplement the Standard Testing Protocol (STP). Include the CSS# if you have one. Please note that a CSS# is required for all GLP studies, whether there are specific changes or additions to the STP or not.
Sample ID / Lot#	List your sample ID number and / or lot number the way you want it listed on your final report. This must match the ID number denoted on the physical samples. If additional space is needed for more information, please include that information on a separate attachment. This field is paragraph formatted (not a column table, so we advise against using bullet points).
Test Parameters	Check the necessary boxes and fill in any fields applicable to your samples and requested testing. For help determining test, contact sales@nelsonlabs.com.
Sample Preparation	Provide an image/diagram/photo of the device portions to be included in testing. List any portions of the device or packaging that should be removed and excluded from testing, and which portions of the device should be included. Add any disassembly instructions.
Test Information	Check the necessary boxes applicable to your samples.
Safety Requirement	For chemical / hazardous material safe handling and disposal, include SDS with each shipment. Schedule I and II controlled substances cannot be sent without prior notice and consent.
Sample Storage Condition	Check the appropriate boxes to indicate how you would like your samples to be stored while at our lab.
Shipping Condition	Check the appropriate boxes to indicate the condition of how you shipped your samples.
Sample Disposition	Check the boxes to indicate how you would like us to handle your sample disposition. If Discard Samples is checked, your samples will be disposed. If “Return Samples” is checked, your samples will be returned to the person listed in the “Sponsor Information” section per the courier listed on the SSF form. If “Return Shipping Container” is checked, only the shipping container will be returned per the courier listed on the SSF form.

Sponsor Information

Billing Information

Sample Id / Lot #: (To be included in final report)

Test Parameters

Sample Preparation (Attach a photo for additional instructions)

List Part(s) of the test article that should be excluded

List Part(s) of the test article that should be tested

Special Instructions

Test Information

Sample Disposition

Shipping Condition

Sample Storage Condition

Test Selection

Sponsor Information

Billing Information

Sample Id / Lot #: (To be included in final report)

Test Parameters

Sample Preparation (Attach a photo for additional instructions)

List Part(s) of the test article that should be excluded

List Part(s) of the test article that should be tested

Special Instructions

Test Information

Sample Disposition

Shipping Condition

Sample Storage Condition

Test Selection

Biocompatibility Sample Submission Guide

Thank you for choosing us for your testing. This guide will walk you through how to fill out the sample submission form.