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FREE CytoDrop™ Slides Request Form

Complete this form to request a complimentary box of CytoDrop Slides for Metaphase Chromosome Analysis from SciGene.

Available for U.S. and Canadian customers only.

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* 1. Person completing this form:

Name

Title

Email Address

Direct Phone

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* 2. Number of chromosome slides prepared per day for G-banding:

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* 3. Number of patient cellular samples analyzed using FISH, per week?

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* 4. Average number of FISH probe hybridizations per week?

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* 5. Volume of probe solution used per hybridization?

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* 6. Address for shipping samples:

Attn or Dept

Organization *

Address *

Address 2

City *

State *

ZIP or Postal Code *

Country

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* 7. Comments:

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