QSA - Qualitative Screening Analysis

Please enter your address. If your current address has not changed, it is sufficient to indicate your lab code and email address.

QSA
 Lab code:*

 Titel:

 Name:

 Company:

 Department:

 Street:

 ZIP/city:

 Country:

 Email:*

 Telephone:

 Fax:

     these boxes must be filled in!

 1. Results - Urine

  Detected drugs (class or single drug)

Applied method*

   1. 

   2. 

   3. 

   4. 

   5. 

   6. 

   7. 

   8. 

   9. 

  10.

      

 2. Results - Serum

  Detected drugs

  

  

  

Interpretation 

  (class or single drug) 

Applied method*

Concentration

Unit

toxic  

not toxic

  1. 

 

  2. 

 

  3. 

 

  4. 

 

  5. 

 

  6. 

 

  7.

 

  8. 

 

  9. 

 

 10.

 

      * method codes         
                   

    
 3. Interpretation ot the results
     

 

Before sending the results, please ensure that all data entered are correct.
       

          

           

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