Agilent 2200 Tapestation Service Request FormWebsite: cgs.hku.hkContact Persons: Allen Chu / Carlos ChoiContact No: 2831-5467 / 2831-5477 Fax No.: 2818-5653Email: tapestation.cgs@hku.hkOrder No.: TS - _______________________________________

User InformationProject Name/ID:

Department:

Billing Account:

Sample Submission Date (yyyy-mm-dd):Signature:

Fax:

Billing Address:

User Name: User Email:

P.I. Email:P.I. Name:

User Contact No.:

ServiceType of Service:

High Sensitivity D5000 ScreenTape (No. of samples: __________)

Run Only Service (Self Service) (No. of time slots: _________)

Other:

TS008

(No. of samples: __________)

TS009

Sample InformationType of Sample:

Human Mouse Rat Other:

Culture cells, line: Tissue, type:

Sample Storage: RT -20°C -80°C4°C

Biohazard Samples: NoYes

Submission Requirements

0.5 mL tubes>= 5 μL

Detection range Tubes formatVolume10 - 1000 pg/μLHigh Sensitivity DNA ScreenTape10 - 100 ng/μLGenomic DNA ScreenTape

Note:- Please select options as appropriate.- For further information, please refer to our website: "cgs.hku.hk".- We DO NOT accept any sample with potential biohazard.- For Research Use Only. Not for use in diagnostic procedures.- For personal data protection, please be reminded that the submitted sample IDs shouldNOT carry any personal information such asthe HKID or passport numbers, the laboratorynumbers of patient reports, or the patient IDs of hospitals.- Please refer to the Privacy and Personal Data Protection Policies at http://cgs.hku.hk/portal/index.php/policies for information on personal data protection and handling by CGS.

Total RNA/DNA samples for NGS service at CGS? Yes No

Smear Analysis: From bp to bpBy default, 200bp to 1000bp will be included for High Sensensitivity D1000Screentape unless specified otherwise.

Sample InformationNote:- For samples with more than 8 letters long, kindly provide an electronic copy excelfile with sample order and information at tapestation.cgs@hku.hk

Sample ID Conc. (ng/μL) Volume (μL) Remarks

1

2

3

4

5

6

7

8

9

10

1112

13

14

15

Sign Date Remarks

Order receive

Sample transfer to -80°C

Tapestation run, report printing Exp Start

Data QC and upload

Data quality approval

Email results to user Completion

Sample Tracking

For Official Use

Sample received by

Screentape ID

Invoice

Tapestation Operation Checklist

Remove screentape package - tap to remove bubbles in wells Vortex and centrifuge down samples Remove strip caps and load to tapestation

Load Tapestation loading tips Select sample well in use and enter sample names

Terms of Use

- We highly recommend using instrument brand reagents andconsumables as other are not tested on the machine.

- CGS cannot be made liable for sub-optimal or no data production ifother brand reagents and consuables are used.

- Users will be held responsible for instrument damage if improperhandling or incompatible reagents are used.

Completion

Remarks

Unit Price Qty

TS $ $

TS $ $

$Total:

Payment (For Official Use)Sub total (HK$)Item

Job done by: Date:

v20181126

QA/QC Supervisor: Date: