Mass Spectrometry Resource for the Study of Biological Complexity

Download Mass Spectrometry Analysis Order Form [word]

VCUMass Spectrometry Resource for the Study of Biological Complexity
Mass Spectrometry Analysis Order Form
Date:__________________________			Department of Chemistry Oliver Hall, Education Wing 1001 West Main Street P. O. Box 842006 Richmond, Virginia 23284-2006 804 828-7487 FAX: 804 828-8599 TDD: 1-800-828-1120
General Information
Name of Submitter		Position of Submitter
E-mail		Faculty Approval
Phone Number		Budget Code
Sample ID		Department/Institution
Type of Service
ESI-MS			LC-MS/MS (Protein Identification
High Resolution ESI (Exact Mass)			LC-MS/MS, (includes SRM and MRM)
ESI-MS/MS			MALDI-TOF MS
LC-MS			MALDI-TOF peptide mass mapping
Use of Mass Spec. Equipment (AUTHORIZED PERSONS ONLY)	ESI MS (LCT)		ESI MS LCQ-Deca Xp plus		MALDI-TOF MS

Sample Information 1. Are any buffers, detergents or salts present? No Yes List ____________________ 2. Was sample purified? No Yes List _______________ Solvent used _______________ 3. Solution concentration ____________________ Solvent is ____________________ 4. Radioactive? Irritant? Other known hazards _________________________ 5. Chemical Formula: ___________________________ 6. Molecular Mass: ______________________________ Proposed Structure:
				File #: MSRSBC use only