We use cookies and similar tools to give you the best website experience. By using our site, you accept our websites privacy policy . . Opens in a new tab

Anti-infectives Screening Core Anti-infectives Screening Core In Vivo Assay Order Form

Purple hero (default)

Anti-infectives Screening Core In Vivo Assay Order Form

Indicates required field

To request an in vivo assay from the Anti-infectives Screening Core, please complete and submit the form below.

First Name:

Last Name:

Email Address:

Address:

Phone Number:

Number of Compounds:

Pathogen Requested:

Treatment:

Compound Name 1:

Dosage (mg/kg):

Number of Days of Treatment:

Weight Sent (mg):

Vehicle (typically 2 percent methylcellulose, 0.5 percent Tween® 80):

Route of Administration (intraperitoneal injection or oral):

Compound Name 2:

Dosage (mg/kg):

Number of Days of Treatment:

Weight Sent (mg):

Vehicle (typically 2 percent methylcellulose, 0.5 percent Tween® 80):

Route of Administration (IP, Oral):

Compound Name 3:

Dosage (mg/kg):

Number of Days of Treatment:

Weight Sent (mg):

Vehicle (typically 2 percent methylcellulose, 0.5 percent Tween® 80):

Route of Administration (IP, Oral):

Compound Name 4:

Dosage (mg/kg):

Number of Days of Treatment:

Weight Sent (mg):

Vehicle (typically 2 percent methylcellulose, 0.5 percent Tween® 80):

Route of Administration (IP, Oral):

Compound Name 5:

Dosage (mg/kg):

Number of Days of Treatment:

Weight Sent (mg):

Vehicle (typically 2 percent methylcellulose, 0.5 percent Tween® 80):

Route of Administration (IP, Oral):

Specific comments, requests, or questions:

Asterisk indicates which fields are required.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Thank you for printing content from NYU Langone Health. © 2024 NYU Grossman School of Medicine.