Mimix Made-to-order Reference Standards Request Form

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Contact information

First name *

Last name *

Email address *

Business phone Optional

Company *

Country *

Zip code / postal code * Optional

Product specifications

Format Optional

Number of variants of interest Optional

Gene symbol(s) (e.g. BRCA1) and/or variant(s) of interest (e.g. HGVS) Optional

Allele frequency/copy number for each variant Optional

Quantity, including unit (e.g. ug, FFPE section/block size) Optional

Desired delivery date (typically turnaround times are 4-12 weeks) Optional

Optional quality control options

Whole exome sequencing Optional

Whole genome sequencing Optional

Intended use

Please provide details Optional

For commercial use Optional

For research use only. Not for use in diagnostic procedures.

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