Request for Quotation

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Study Information

  • Organization Name*

  • Name of Sponsor

  • Study Title*

  • Protocol No.

  • Trial Phase

  • Institutions participating in the clinical trial*

  • Study Period*

  • No. of Subjects*

  • No. of visits*

  • Requested items*

  • How to deliver the results

    • Web/etc

    • EDC upload

Sample Delivery/Storage

  • Consignment of sample shipment*

  • Sample storage*

  • Whether to analyze separate items after storage, or deliver to a third party

Contact person

  • Name/position*

  • Contact Number*

    - -
  • Email*

  • Attach file

Consent to collection and use of personal information

  • Purpose of collection : To verify the identity of the service and to reply to the result, to obtain necessary information and to respond to the service progress
  • Collection items : name, contact information, e-mail address, organization name
  • Retention and use period : Storage for 6 months after inquiry processing and disposal
  • GCCL collects only the minimum amount of personal information necessary to use the service
  • Failure to enter the required personal information items may result in restrictions on the use of the service

Do you agree to collect and use the above personal information? (Required)