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Custom Peptide Quote Request Form
for 1 Antibody

Phone: 800-435-2080
Fax: 508-435-8508
email: peptide@qcb.com

Note: Required Fields are in Red

Preferred method of contact:
First Name: Last Name:
Telephone Number: Ext:
Fax Number: E-mail Address:
Institution/Company: Department:
Address:    
City:    
State:    
Zip:    
Step 1: Select a host animal

Please select the desired species (standard number of animals is noted by each species).
We can always add additional animals if you wish.  Rabbit is the most common for
polyclonal antibody production.

If other, please name the desired species here:

Please select the number of additional animals to immunize (optional)




Step 2: Antibody selection package Select your desired Custom Antibody Service Package
A representative will contact you to further discuss each Service Package and answer any questions.

(Click here for our package selection chart)

Will you need your peptide conjugated to a carrier protein?
(An additional charge of $149.00 will be added to your quote if selected.)