NMR Services Requisition


Requisition Form for UBC Chemistry NMR Services
Welcome to UBC Chemistry's NMR sample services.



* First Name:

* Last Name:

* Status:
Choose one of the following answers

* Supervisor:

Lab Phone:

* Department, Institution or Name of Your Workplace:

* E-mail:

* Date of Sample Submission:

* Speedchart: (for outside client, please use OOOO)

Billing address (if you are a new non-UBC customer) and PO number


Please provide information about your samples

* Sample Name:

HelpPlease use the same name to label your NMR sample
* Solvent (Please indicated if it is deuterated or not. For example, write CDCl3 instead of chloroform.):

* Approximate Sample Concentration:

Sample Structure (Provide a chemdraw file if you wish):
Please upload at most one file

Upload files
Sample Handling Safety (Please provide instructions on how to handle your samples safely if special precautions need to be taken):

Sample Storage (Please privide instructions how to store your sample):




Please indicate if you have a preferred spectrometer:
Choose one of the following answers

* Please choose which type of data you would like to collect:
Choose one of the following answers

Please provide other detailed instructions if you have any:


(The following questions are ONLY filled by NMR staff)

Date of Completion:

Data Collected by:
Choose one of the following answers

Spectrometer Hours:
Only numbers may be entered in this field.

Total Dollar Charges:
Only numbers may be entered in this field.

Technician Notes: