Stepping Stone in Quality Management

Subscribe to the on-line QC Management program

Laboratory Information

Laboratory Name*

Address*

City*

Zip/Postal*

State/Province*

Country*



COST:
Number of instruments
to be managed on-line*		 NOTE: you will be charged
a monthly fee for each instrument
at the end of each month.
You can add or remove
instruments at any time and the
monthly fee will be
adjusted accordingly.
My interest is...** Click here to learn more
Interfacing solutions Click here to learn more

NOTE: initial one time setup fee of $1,650.00 is applicable.

Payment Method:

SETUP INFORMATION:
List all instrument models
you plan to manage on-line		 Instrument Model:




Manufacturer:




List all analytes/tests
you plan to manage on-line		 Test Name:




Test Units:





Product Manufacturer Lot # QC Level/Description Start Date
(mm/dd/yyyy) 		Expiry Date
(mm/dd/yyyy)
List all QC Lots
you plan to
manage on-line























List all Qualitative Results
you plan to manage on-line		 Qualitative Results:









* - mandatory field
** - monthly subscription fee per module per instrument

Upon submission of this form, you will receive a confirmation email along with application form to complete
the subscription process. Please print out the form, complete it and fax it to +1-905-468-8795.