Order Form - nrlquality

For the best experience of NRL website, please view this site in either Microsoft Edge, Google Chrome, Safari internet browsers rather than Internet Explorer.

Skip to main content

61 3 9418 1111
Contact us

Home
About
Products & Services
Knowledge Base
News & Events

Home
About
Products & Services
Knowledge Base
News & Events

Order Form

"*" indicates required fields

Page 1 of 3

33%

Participant Information

Participant Type

New Customer

Existing Customer

NRL Participant ID

Organisation Name*

Department*

Street Address*

City/Suburb*

State

Country*

Postcode

Contact Name*

Contact Position*

Phone*

Fax

Email*

Billing Information

Billing information is same as participant information?*

Yes

No

Organisation Name*

Department*

Street Address*

City/Suburb*

State

Country*

Postcode

Contact Name*

Contact Position*

Phone*

Fax*

Email*

Shipping Options

International participants Only*

Door-to-Door - NRL will ship to your facility and add shipping and customs clearance costs to your invoice.

Door-to-Airport (not applicable for NAT programs) - We will ship to the airport of entry and add shipping costs only to your invoice; you will arrange and pay for customs clearance.

Do you require an import permit for EQAS samples?*

Yes

No

If Yes, do you have an import permit for shipping time period?*

Yes

No

Authorisation

By placing your order you agree to the Standard Terms and Conditions and the Permitted Use of Materials

Authorisation Name*

Signature*

Payment Options

Payments options will be specified on the invoice

Purchase Order Number (Mandatory for Australian customers)

Serology EQAS

Program Code: MMBS4310

Multimarker Blood Screening Serology | Test Events x Samples: 3 x 10

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: HEPM435

Hepatitis Serology | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: RVSS435

Retrovirus and Syphilis Serology | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: TRCH435

TORCH and EBV Serology | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: COVS432

SARS-CoV-2 Antigen | Test Events x Samples: 3 x 2

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: COVS434

SARS-CoV-2 Serology | Test Events x Samples: 3 x 4

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Molecular EQAS

Program Code: NATA4310

Multimarker Blood Screening Molecular | Test Events x Samples: 3 x 10

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: MMPF4310

Multimarker Plasma Fractionation Molecular | Test Events x Samples: 3 x 10

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: CMVN435

CMV Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: RASH435

Viral Exanthems Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: RESP435

Viral Respiratory Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: RESV435

Extended Viral Respiratory Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: RESB435

Bacterial Plus Respiratory Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: STIC435

Sexually Transmitted Infections Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: HIVL435

HIV Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: HBVL435

HBV Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: HCVQ435

HCV Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: HPVN435

HPV Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: TTIM435

Transplant-Transmitted Infectious Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Point of Care and Specialised EQAS

Program Code: CNTP435

C. trachomatis, N. gonorrhoeae and T. vaginalis Molecular Point of Care | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: CNTP432

C. trachomatis, N. gonorrhoeae and T. vaginalis Molecular Point of Care | Test Events x Samples: 3 x 2

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: DTSI432

Dried Tube Sample HIV and Early Infant Diagnosis Molecular Point of Care | Test Events x Samples: 3 x 2

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: DTSI435

Dried Tube Sample HIV and Early Infant Diagnosis Molecular Point of Care | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: DTSB435

Dried Tube Sample HBV Molecular Point of Care | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: DTSB432

Dried Tube Sample HBV Molecular Point of Care | Test Events x Samples: 3 x 2

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: DTSC435

Dried Tube Sample HCV Molecular Point of Care | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events

1

2

3

Program Code: DTSC432

Dried Tube Sample HCV Molecular Point of Care | Test Events x Samples: 3 x 2

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: DWBC425

Dried Tube Whole Blood HCV Molecular Point of Care | Test Events x Samples: 2 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: LEPN435

Leptospirosis Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: MTBN435

Mycobacterium Molecular Point of Care | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: MTBN432

Mycobacterium Molecular Point of Care | Test Events x Samples: 3 x 2

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

Program Code: HTLD435

HTLV Molecular | Test Events x Samples: 3 x 5

(A) No. of Programs

Please enter a number greater than or equal to 0.

(B) Extra Panels * (Sample only sub.)

Please enter a number greater than or equal to 0.

(C) Test Event Information

Full Subscription (All Test Events)

1

2

3

*Extra panels of samples can be purchased at 50% of the program's price. There is a limit of one additional program per customer

Additional Comments

Standard Terms and Conditions

1. By placing your order you agree to these Standard Terms and Conditions. An invoice will be issued upon receipt of your order.
2. All prices are in the currency as indicated. Prices are subject to change.
3. Prices exclude shipping and handling fees. These will be added to your invoice.
4. Prices for Australian participants exclude GST. GST will be added to your invoice.
5. Prices for international participants exclude applicable customs duties and taxes and holding fees, which shall be your sole responsibility.
6. Payment in full is required before first shipment date.
7. Risk in the test materials passes to you at the time of collection of the test materials at NRL’s premises. You are encouraged to consider obtaining appropriate insurance coverage for the shipping and delivery of the test materials.
8. Due to the nature of these programs and test materials, all sales are final.
9. Shipments and/or performance information may be withheld for overdue accounts.
10. Test samples contain pathogenic materials: you assume all risk and responsibility for their receipt, handling, storage use and disposal.

Permitted Use Of Materials

Some EQAS material provided to NRL have restrictions for further use. This material is considered proprietary to NRL and its collaborators. For the "Permitted Use of Material" please refer to www.nrlquality.org.au.

Consent*

I agree with T&Cs*

Phone

This field is for validation purposes and should be left unchanged.

Page last updated: 3 April 2023

Contact Us

4th Floor, Healy Building
41 Victoria Parade
Fitzroy VIC 3065

+61 3 9418 1111
+61 3 9418 1155
[email protected]

Products & Services

QConnect
EQAS
Evaluations
Testing
Training
Biobank
Research & Development
Point of Care QA

NRL acknowledges the Aboriginal lands on which we live and work and pays respect to Traditional Owners, Ancestors and Elders.

Sign up for our newsletter

© NRL Quality 2023

Copyright Privacy Policy Disclaimer