Lab Request Forms

Lab Request Forms

Assay Technology has a variety of lab request forms (LRFs), which act as a client work order and chain of custody. Each LRF requires similar information necessary for sample log-in and the calculations on reports. When you buy a badge, we include the appropriate Lab Request Form for that badge; however, the included copy of the form doesn’t have to be the one you use.

There are other options for providing the necessary information to the lab:

  • A customer could use their own Lab Request Form/COC. Be sure to include the badge serial numbers.
  • Download our free SmartBadge app. Record the sampling event on our app and have the LRF created automatically.
  • Use the fillable PDF versions of our lab request forms below. Fill in your “report to” information once and then print as many copies as you want.

Lab Request Form (LRF) templates:

General COC: A general IH Chain of Custody. Can be used for anything, but typically active samples (tubes, cassettes, etc.)
Multi Badge LRF: 10 badges, one LRF. Easy!
525-25: Organic Vapor TraceAir II® IAQ Panel
525: Organic Vapor TraceAir II®
543: Acetic Acid
545: Methanol
546: Organic Vapor – High Capacity
549: Organic Vapor – HCFC
555: Ethylene Oxide
566: Organic Vapor
571: Aldehydes
574: Halogenated Anesthetic Gases
575: Nitrous Oxide
581: Aldehyde TraceAir® II
584: Ammonia
585: Organic Amines
586: Ozone
587: Hydrogen Peroxide
592: Acrolein
593: Mercury Vapor
594: Nitrogen Dioxide
595: Ethyl 2-Cyanoacrylate
596: Phenol

Filling out your LRF

Filling out an Assay Technology Lab Request Form

Things to note on the LRF:

The Assay Technology customer number (“Assay Tech Contact No.” in the image to the left) is an optional field, but is also the easiest way for us to match your sample to your account. Please note that this is not your phone number, but a personal account number assigned to individuals who receive reports. Feel free to contact us via email or phone if you do not know your number.

It should also be noted that lab reports are typically emailed out. If you would prefer a hard copy or a faxed report, please be sure to indicate this on the LRF.

For larger projects, we recommend using either our online PDFs to fill out sampling information or address labels. This sticker can be placed over the “Send Lab Report To” section. Labels can be provided upon request, simply ask at time of order or contact customer support with your information.
We also recommend trying our SmartBadge App, where project information can be filled in on your device and compiled together automatically. Upon project submission, a PDF chain of custody is generated that is automatically sent to the lab, while a PDF copy can be emailed to desired email address.

For any other inquiries please call our live customer service department, open M-F 5am-5pm PST, at (800) 833-1258 opt. 4 or email us anytime at