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Antibody/Product Problem Reporting Form (PROB-1)
Use the form below to report a problem with a product/antibody. Red fields are required.
Investigator Name:  *  
Institution:  *  
Email Address:  *  
Phone Number:  *  
FAX Number:  *  
Shipping Address:  *  
Address 2:  
City:  *  
State:  *  
Province/Country (outside US):  
Zip/Postal Code:  *  
Product Name:   Catalog #:   Lot #:
Order Date:  
Test Dates:  
Note: Enter dates in MM/DD/YYYY format. Use "," to separate multiple test dates.
Ordered from: ADI   Distributor (name): 
In what form did you receive: Yes No  
How stock solutions were made: (buffer & volume)  
How did you store:  
What techniques were used: Western   IHC   IF   ELISA   IP   Other: 
Primary Antibody diluent/buffer:  
Primary Antibody dilutions tested: (ug/ml)  
Secondary antibody used:  
Secondary Antibody dilutions tested: (ug/ml)  
Source of Secondary Antibody Samples: Mouse   Rat   Human   Other 
What tissues or cell lines were tested?  
Has this product worked before? Yes   No  

Describe the problem (no bands, too many bands, no staining, etc) :

Please enter any comments or special instructions :

Verify Code: