EQAS participation form

You can participate for 5 markers. Every quarter you can decide to participate. Please tick for every round and marker. The price is 120 euro per marker per quarter

HBsAg: 1st quarter 2nd quarter 3rd quarter 4th quarter
a-HIV-1: 1st quarter 2nd quarter 3rd quarter 4th quarter
a-HCV: 1st quarter 2nd quarter 3rd quarter 4th quarter
a-HTLV-1: 1st quarter 2nd quarter 3rd quarter 4th quarter
a-Trep.p.: 1st quarter 2nd quarter 3rd quarter 4th quarter
Name:
Department:
Institute:
Adress:
Postal code:
City:
Country:
Signature
Telephone number:
Telefax number:
e-mail:
VAT code (only EU countries)
Print this form and fax it to bioQControl. We will send an proposal within 10 working days.
Telephone: ++31-70-340.1670 Telefax: ++31-70-340.1671
 
SerologicalTesting