Laboratory Analysis | Specialty Chemical Finishing Products

Sample Submission Form

Our easy-to-use sample submission form is part of Asterion’s commitment to continually enhance sample analysis and submission procedures. Please note the following to ensure quick and accurate response to your sample request.

Before submitting your sample request, please obtain a free sample submission kits from your Asterion representative. The kits include all required packing materials and shipping documentation that are specifically designed to meet regulatory requirements.
Customers may submit up to ten sample requests per submission.
Every sample is assigned an identifier number for testing at Asterion’s advanced analytical laboratory.

As you complete this form, you will be instructed how to label your sample bottles. Should there be any questions with your submission, an Asterion technical representative will contact the person provided on the submission.

Sample Submission Form

Your information

Name *

First

Last Name *

Last

Company Name *

Email Address *

Phone Number *

Are you experiencing problems? *

Yes

Will you require an Asterion approved sample kit for this analysis request? *

Yes

Will you require an Asterion approved sample kit for your next analysis request? *

Yes

Describe, in detail, the problems you are experiencing *

Number of samples submitting (maximum of 10): *

1st sample name *

Testing for 1st sample requested *

2nd sample name *

Testing for 2nd sample requested *

3rd sample name *

Testing for 3rd sample requested *

4th sample name *

Testing for 4th sample requested *

5th sample name *

Testing for 5th sample requested *

6th sample name *

Testing for 6th sample requested *

7th sample name *

Testing for 7th sample requested *

8th sample name *

Testing for 8th sample requested *

9th sample name *

Testing for 9th sample requested *

10th sample name *

Testing for 10th sample requested *

Additional comments

Your uniquely generated identifier for this group of samples