repeat sample request form

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Additional/Repeat EQA Samples Order Form
Requested by:
Date:
Laboratory ID
number or address
Repeat samples:
Distribution
number
Sample number(s)
Quantity
Total number of samples
Additional Samples:
Distribution
number
Sample number(s)
Quantity
Total number of samples
Repeat samples will normally be sent with
the next distribution.
Only complete this section if you want to
pay for earlier delivery.
Invoice Address (if applicable)
Customer Order No.
VAT No.
A limited number of repeat samples are available free of charge for participants who experienced
technical difficulties with a distribution.
Please return to:
The Organisers,
Public Health England,
Food and Environmental Proficiency Testing Unit (FEPTU),
61 Colindale Ave, London, NW9 5EQ, UK.
Fax: +44 (0) 20 8200 8264
E-mail: [email protected]
FEPTU105.01
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