8210 Austin Ave.
Morton Grove, IL 60053, USA
Phone: 847-967-6000
Fax: 847-967-1214
HPLC/SFC Chiral Screen Submission Sheet
Compound Structure/Name
Contact Information:
Or attach separately
Submission Date:
Primary Contact:
Alternate Contact:
Company:
Address:
City:
State:
Zip Code:
Country:
Phone:
Fax:
Email:
Name:
Separation Requirements:
Do you want this screening sample returned?
Analytical
HPLC?
SFC?
Preparative SFC?
If yes, projected separation quantity
nonGMP
cGMP
Yes
Safety and Handling
Properties and Appearance:
MSDS Available
(If yes, include a copy with sample)
Hazardous Material:
Storage Conditions
(ambient if left blank):
No
Note: All screening samples are destroyed after analysis is
complete. No peaks are collected during the screening and
any isolation work requires an additional quote.
Powder
Yes
Yes
No
No
Crystalline
Color:
λmax(nm):
Chemical
Purity
(%AUC):
Special Handling Requirements:
Known Chiral Chromatographic Methods: (Please include a copy of any chromatograms)
Column:
Manufacturer:
Mobile Phase:
Flow Rate:
Wavelength (nm):
v. 3
Oil
8210 Austin Ave.
Morton Grove, IL 60053, USA
Phone: 847-967-6000
Fax: 847-967-1214
Stability
Light:
Moisture:
Temp (> 40°C)
Stable
Stable
Stable
Decomposes
Decomposes
Decomposes
Unknown
Unknown
Unknown
Stable
Stable
Decomposes
Decomposes
Unknown
Unknown
Stable
Stable
Decomposes
Decomposes
Unknown
Unknown
Soluble
Soluble
Soluble
Soluble
Soluble
Soluble
Soluble
Soluble
Soluble
Slightly
Slightly
Slightly
Slightly
Slightly
Slightly
Slightly
Slightly
Slightly
Acids
Acetic Acid (>1%)
Trifluoroacetic Acid (>1%)
Bases
Triethylamine (>1%)
Diethylamine (>1%)
Solubility
Water
Methanol
Ethanol
2-Propanol
Hexanes
Ethyl Acetate
CH2Cl2
Chloroform
Acetonitrile
Decomposes
Decomposes
Decomposes
Decomposes
Decomposes
Decomposes
Decomposes
Decomposes
Decomposes
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Other:
COMMENTS:
Instructions:
Please send or email this completed form along with your sample(s) to:
[email protected]
Ted Szczerba
8210 Austin Ave.
Morton Grove, IL 60053-051
We would like to have at least 10-20 mg of sample. If you are unable to send us 10 mg, you must include sufficient
solubility information. If the compound you are sending is not commercially available, please inquire if you need a
confidentially agreement signed before you send us your sample.
v. 3