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Radioactive Material Order Report Form

Please use this form to notify us when you have ordered radioactive material. 

E-mail
Principal Investigator
End User
Location (Room & Building)
Permit Number
Radionuclide H-3 C-14    P-32    P-33   S-35   I-125   Other--Write in comments below.
Activity and form: (e.g. "250 uCi dATP" or "2 x 5mCi methionine" or "250 uCi dCTP, 1mCi UTP")
 
Company Ordered From GE Healthcare   Perkin Elmer    MP Biomedicals Other--Write in comments below.

Comments: