Aushon SearchLightSample Testing Quote Request Form

Shipping Schedule:

_____ shipments of approximately _______________ samples each

Testing Schedule:

In batches

_____ batches of approximately _________________ samples each

All samples will be tested at one time

Time Frame:

Projected Start of Study: _______________________________________ mo / yr

Projected End of Study: _______________________________________ mo / yr

Please indicate any known infectious disease associated with the samples:

__________________________________________________________________________________

Standard Aushon procedure involves analysis of samples in duplicate. Please indicate here if you would prefer pricing for testing in triplicate:

Please include triplicate testing in the price quotation

The data report is typically supplied in an Excel format. Please indicate any special requirements or preferences regarding the data report below:

Document # 140-0041-A

Requested By:*Name _____________________________________________________________________________________________________

*Institution __________________________________________________________________________________________________

Address ____________________________________________________________________________________________________

City __________________________________________________________*State _______________________________________

Zip _________________________________________________________ Country ________________________________________

*E-mail _____________________________________________________________________________________________________

*Phone __________________________________________________ Fax_______________________________________________

(*Required Fields)

Amniotic FluidBALCell LysateCSFCrevicular fluidCulture SupernatantEDTA PlasmaHeparin PlasmaSodium Citrate PlasmaSerumSynovial fluidTissue Homogenate*UrineOther - ________________________________*Please check here if you are ordering micro-BCA(total protein) testing

HumanMouseRatPorcineCanineBovinePrimate - RhesusPrimate - CynomolgousPrimate - _______________________________Other - ________________________________

Sample Matrix Species of Samples

© 2010 Aushon Biosystems Inc. All rights reserved. The trademarks and service marks shown are trademarks of Aushon Biosystems Inc. or its affiliates and may be pending or registered in the United States and other jurisdictions. Other marks are the property of the owners of those marks.

Questions:

Please contact an Aushon BioSystems Specialist with any questions regarding completion of the Test Requisition Form, preparation of samples, or the sample testing process at 877-287-4661 or e-mail us at info@aushon.com Aushon

BIOSYSTEMS

Aushon BioSystems, Inc. 43 Manning Road Billerica, MA 01821 1-877-AUSHON-1 International +1 978.436.6464 Facsimile: 978.667.3970 www.aushon.com

This sample set is part of an ongoing study.

Please refer to test parameters (panels, sample dilutions) used for SL _________________________________________________

Menu of Assays Testing Request Form

Multispecies Intracellular

pAKT-1 (Ser473)pAKT-1 (Thr308)Cortisol*COX-1*pERK 1/2 (Thr202/Tyr204)pERK 2 (Thr202/Tyr204)pHsp27 (Ser15)pJNK2 (Thr183/Tyr185)pMEK1 (Ser217/221)pP38a (Thr180/Tyr182)

Human Analytesa2-Macroglobulin Acrp-30 (Adiponectin)Ang-2Apo A-1 Apo B-100 AR (Amphiregulin)A-SAABCA-1 (CXCL13)b-NGF b-sAPPBDNFBD-2BMP-9 NEW!Cathepsin-D CC16CD14CD30 (TNFR SF8)CD40LCGaClusterinCNTF COX-2C-peptide hsCRP (C-reactive protein)D-DimerE-CadherinEGFEGFRENA-78 +Endoglin NEW!Eotaxin +Eotaxin-2Eotaxin-3ER (Epiregulin)ErbB2E-SelectinExodus-2FasLFGF basic +FibrinogenFibronectinG-CSFGDNFGM-CSFgp130GROa +GROgHB-EGFHCC-4 (CCL-16)HGFHGHI-309ICAM-1ICAM-3IFNa* * * IFNg +IgE

IGFBP-1IGFBP-2IGFBP-3IL-1a +IL-1b +IL-1raIL-1RIIL-1RIIIL-2 +IL-2RIL-2RgIL-3IL-4 +IL-4RIL-5 +IL-6 +IL-6RIL-7IL-8 +IL-9IL-10 +IL-11IL-12p40 (p40/homodimer)IL-12p70 (heterodimer) +IL-13 +IL-13Ra1IL-15 +IL-16IL-17AIL-17EIL-18* * *IL-23InsulinIP-10 +ITACKGFLeptinLIFL-SelectinLymphotactinMCP-1 +MCP-2MCP-3MCP-4M-CSFMDC +MIFMIG +MIP-1a +MIP-1b +MIP-1dMIP-3a MIP-3b MIP-4 (PARC)MMP-1MMP-2MMP-3MMP-7MMP-8MMP-9MMP-10MMP-13MPIF-1 +MPO (Myeloperoxidase) NAP-2NGALNT3NT-proBNPOPG (Osteoprotegrin)OPN (Osteopontin)*PAI-1 Active +

PAI-1 TotalPAPP-APD-1 NEW!PDGF-AAPDGF-ABPDGF-BBPECAM-1PEDFPLGF (Placental Growth

Factor)ProlactinProtein CP-SelectinRAGERANKRANK LRANTES +RBP4*ResistinSCFSDF-1b SHBGSP-CSP-DSubstance PTARC +TFF-3 (urine only) NEW!TGFaTGFb1*TGFb2*ThrombomodulinTIM-1 (urine only) NEW!TIMP-1TIMP-2Tissue FactorTNFa (Active Trimer) +TNFa (Monomer + Trimer)TNF-RITNF-RIITPOTRAILTSLP TSP-1 (Thrombospondin-1)TSP-2 (Thrombospondin-2)TWEAKVCAM-1VEGF +VEGF-CVEGF-DVEGF-R1VEGF-R2 VisfatinVon Willebrand Factor*

Mouse AnalytesAcrp-30 (Adiponectin)CNTFCRP (C-reactive protein)EotaxinE-Selectin Exodus-2GM-CSFICAM-1IFNg +IgA* *IgG1* *IgG2a* *IgG2b* *IgM* *IL-1a +IL-1b +

IL-1raIL-2 +IL-4 +IL-5 +IL-6 +IL-10 +IL-12p40IL-12p70 +IL-13 +IL-17IL-18* * *IL-23IL-27IP-10KC +KDR/VEGF-R2L-SelectinLeptinMCP-1 (JE)MCP-5MDCMIP-1aMIP-1bMIP-2MIP-3bMMP-2MMP-3MMP-9OPN (Osteopontin)PDGF-AAPDGF-ABPDGF-BBP-SelectinRANTESResistinSDF-1bTARCTGFb1*TNFaTNF-RITNF-RIIVCAM-1VEGF

Rat AnalytesAcrp-30 (Adiponectin)CINC2a CRP (C-reactive protein)EotaxinFractalkineGDNF GM-CSFGRO/KCIFNgIL-1aIL-1bIL-2IL-4IL-6IL-10KDR/VEGF-R2LeptinMCP-1MDCMIP-1aMIP-2MIP-3aMMP-2PDGF-ABPDGF-BBRANTES

TGFb1*TNFa

Porcine AnalytesIFNgIL-1bIL-2IL-4IL-6IL-8IL-10IL-12TNFa

Non-Human Primate Analytes

GM-CSFGROgIFNg IL-1bIL-6IL-6RIL-8MCP-1MDCMIP-1a MIP-1bMIP-4MMP-2MMP-3MMP-9NAP-2RANTESSDF-1bTIMP-1TIMP-2TNFa

Canine Analytes IFNg IL-2IL-6IL-10MCP-1TGFb1*TNFa

Bovine AnalytesIFNg IL-1bIL-2IL-4IL-6TNFa

+ Also available in the infrared format

* May not be combined in an array

** Combined only with immunoglobulin isotypes; service only

*** Service Only

© 2010 Aushon Biosystems Inc. All rights reserved. The trademarks and service marks shown are trademarks of Aushon Biosystems Inc. or its affiliates and may be pending or registered in the United States and other jurisdictions. Other marks are the property of the owners of those marks.

Please check the proteins you would like to include in your kit(s).