Agilent 2100 Bioanalyzer Service Request FormWebsite: cgs.hku.hkContact Persons: Tracy Lau / Rachel Li / Jonathan Chan / Lilian ChengContact No: 2831-5477 / 2831-5467 Fax No.: 2818-5653Email: bioanalyzer.cgs@hku.hkOrder No.: AB - _______________________________________

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:

RNA 6000 Nano Assay (No. of samples: __________)

DNA 1000 Assay (No. of samples: __________)

High Sensitivity DNA Assay (No. of samples: __________)

Other:

AB002

AB006

(No. of samples: __________)

AB001

RNA Sample InformationType of Sample:

EukaryoteHuman Mouse Rat Other:

Culture cells, line: Tissue, type:

ProkaryoteBacteria Other:

Total RNA mRNA IVT product Other:

Sample Storage: RT -20°C -80°C4°C

Biohazard Samples: NoYes

Submission Requirements

0.5 mL tubes>= 3 μL

Detection range Tubes formatVolume5 - 500 ng/μL

5 - 500 pg/μL

RNA 6000 Nano Assay

High Sensitivity DNA AssayNote:- 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 should NOT carry anypersonal information such asthe HKID or passport numbers, the laboratory numbers of patient reports, or thepatient IDs of hospitals.- Please refer to the Privacy and Personal Data Protection Policies at http://cgs.hku.hk/portal/index.php/policiesfor information on personal data protection and handling by CGS.

0.5 - 50 ng/μLDNA 1000 Assay

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

Smear analysis: From bp to bp

Total RNA samples for GeneChip service? Yes No

If YES, please prepare RNA with the requirements as stated below whensubmitting samples for Bioanalyzer analysis:

Whole Transcript Expression Exon / Gene ArrayGeneChip miRNA 4.0 Array

Array Type Quantity Concentration>= 2.5 μg >=200 ng/μL>= 2.0 μg >=130 ng/μL

By default, 200bp to 1000bp will be included for all DNA assay unless specified.

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

1

2

3

4

5

6

7

8

9

10

1112

Sign Date Remarks

Order receive

Sample transfer to -80°C

Bioanalyzer run, report printingExp Start

Data QC and upload

Data quality approval

Email results to user Completion

Remarks

Sample Tracking

For Official Use

Sample received by

Bioanalyzer chip ID

Sign Date Remarks

Nanodropconc

A260 /280 RIN

Order

QCPass "√'"Fail "X"

Sample info

Analysis results, QC

DB

1

2

3

4

5

6

7

8

9

10

11

12

A260 /230

BAConc

Invoice

28S/18S

Unit Price Qty

AB $ $

AB $ $

$Total:

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

Job done by: Date:

v20181126

QA/QC Supervisor: Date: