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 select which NMR lab you would like to submit your samples to
Choose one of the following answers

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

If you are requesting quick experiments (1H, 19F, 31P and 13C etc), how soon would you expect to receive your data back?
Choose one of the following answers

Is your sample perishable at room temperature?
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: