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Large Molecule Request for Proposal (RFP)
Fields with colored labels are required.
First Name:
Last Name:
Title:
Company:
Address 1:
Address 2:
City:
State/Province: Postal Code:
Country:
Work Phone: Mobile Phone:
Fax Number:
Email Address:
How Did You Hear About Covance:
World Wide Web Colleague Covance Sales Staff
Tradeshow/Meeting Publications Other
Regulatory Requirements:
GLP OECD MHLW None
Project Type:
Feasibility Method Development/Validation
Method Transfer Sample Analysis Other
Assay Type or Instrumentation:
Kit Assay ELISA Cell Based Assay
Biacore TOSOH TDxFLx
MLA Electra 1600 DELFIA Other
Do You Currently Have A Bioanalytical Method: Yes No
Number of Analyte(s):
Compound Name(s): Expected LLOQ:
Standard(s) Available: Yes No
Sample Pretreatment/Extraction:
Filtration Affinity Chromatography
Liquid/Liquid Solid Phase Extraction
Protein Precipitation Other
Derivatization
Storage Conditions, Stability Issues:
Species:
Human Rhesus Monkey Cynomolgus Monkey Canine
Rat Mouse Other
Matrix:
Serum Urine Plasma Other
Anticoagulant Requirements:
Potassium EDTA Sodium EDTA Lithium Heparin
Sodium Heparin Other None
Number of Samples:
Number of timepoints/subject:
Batching requirements:
None All time points for one subject Other
What Are Your Timelines:
(check all that apply and click on the calendar to enter applicable due date)
None at this time
Have Samples In Freezer — Need Analysis To Start Select a Date
Sample Arrival Select a Date
Interim Data Select a Date
Data Due Select a Date
Database Lock Select a Date
Final Report Select a Date
IND Filing Select a Date
Other Select a Date
Samples Will Be Shipped To Covance From Which Area(s):
North America South America Europe Asia
Australia Africa Multiple Sites Other
Number of Sample Shipments:
Study Protocol Status:
Final Draft In Process Other
Will Sponsor Make Protocol Available? Yes No
Report Type:
No Report/Data Tables Only Full Bioanalytical Final Report
Custom Report Other
PK or TK Analysis & Report Needed: Yes No
Is Long-Term Stability Needed In Matrix: Yes No
Notes:
Thank you.
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