Form Ext-3
 for requesting optional extension and termination of custom projects.
International Projects, due to shipping constraints, will not be extended unless it is schedule at the initiation of projects.
 

You will be provide with a scheduled bleed ship dates and expected termination date at the start of projects. All projects will be terminated either on the scheduled termination date or within the next 5-7 working days. We shall attempt to contact you by email/phone. However, it is researchers responsibility to make sure that written instructions are provided for termination and projects extensions. A given protocol, 1 or more animals per projects, can be extended as desired on a monthly basis only. Extension charges are determined by per diem housing, number of injections and bleeds. All projects can be extended as long as desired depending upon the availability of antigen or peptide-protein conjugate. For example, one rabbit can be housed for 1 month for just $* per month per animal (rabbit, chicken, g. pig,, hamster; it includes housing and care, 2 injections, and 2 std. Bleeds). Animals can be bled out ($*/animal) at any time to collect additional blood. Please consult ADI for current charges in others species (sheep, goat, mice, rats, etc). during optional extension period. 

1. Project name or ID. ____________________________________________________

2. Animal #. ____________________________________________________________

3. Schedule Termination Date _______________________________________________

4. Optional Extension requested for: ______(# months); ______________ (specify rabbit #)

5. New Scheduled termination date: ___________________________________________

6. Extension charges @/animal: ___________________________________________

7. Total Extension Charges: _________________________________________________

8. Bleed out: Collect antiserum upon termination ($/animal; ~50-60 ml serum/rabbit)
Bleed out charges: _______________________________________________________

9. TOTAL CHARGES: ___________________________________________________

10. New PO#: ________________________. Note: Most institutions will not allow new charges to be added on an existing PO#, and also refuse to accept shipments if a PO# has already been invoiced and paid. ADI will NOT ship anything until a new PO# is provided. It is the responsibility of the researchers to provide us with applicable PO#.

11. No extension is requested. Terminate all projects as scheduled without any extension and without collecting any bleeds.

Important: All extension requests must be sent in writing by fax or email at least 1 week prior to the scheduled extension. 


Date: _________________; Name of the Person: ___________________; Signature: __________________________

rev. 250519


Alpha Diagnostic International, Inc. - 4638 N Loop 1604 West, San Antonio, TX 78249 USA
Phones: Toll Free In USA: (800) 786-5777; Intl. (210) 561-9515; FAX: (210) 561-9544,
Email
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