Project Interest Form
Point of Contact
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First Name
Last Name
Company/Institute
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Institution Type
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Please Select
Academic / Non-Profit
Industry
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Please provide a brief description of project:
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Approximate sample size
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Assay Services
*
Please Select
IPDA® assay services for HIV
IPDA® assay services for SIV
IPDA® assay services for SHIV
Peripheral blood cell processing services
HIV plasma viral load (standard or ultrasensitive)
Viral cell-associated RNA assay services for HIV, SIV, or SHIV
QVOA assay services for HIV
Total HIV proviral DNA assay services
HIV proviral NFL-SGS
ELISpot/FluoroSpot
Custom Flow Cytometry Phenotyping
Custom Assay Development Services
Other (provide description above)
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