SPSmedical - Testing Submission Form

To submit a testing request or inquiry by either fax or mail, please download our submission form here. Completed forms can be faxed to (585) 359-0167 or mailed to:
	SPSmedical Supply Corp. 6789 W. Henrietta Road Rush, NY 14543 Attn: Testing Services Department
To submit a testing request or inquiry online, please complete the form below and click the submit button. Once the information is received, a representative of the testing services department will review the request and contact you.

Sponsor (final report will be mailed to): * Indicates a required field
* Facility/Company:		Phone:
Street Address:		Fax:
		* Email:
City:		* Verify Email:
State/Province:
Country:
Zip/Postal Code:
Attn:

Services Requested - Select all that apply: Note: Please include cycle parameters for each process in the special instructions section.
Sterilization Process, Steam	Cleaning Validation TIR 12	D-Value Testing - SMC or LSK
Sterilization Process, H₂O₂	Product Validation	Biocompatibility
Sterilization Process, Dry Heat	Indicator Testing	Material Compatibility
Sterilization Process, Peracetic Acid	Package Testing	Feasibility Testing
Sterilization Process, Chemical Vapor	Sterility	Perform Stat (Extra charge)
Sterilization Process, EO Gas	Population Assay	Other:
Sterilization Process, Other:	Bioburden Testing	Other:
Special Instructions:

Select/fill in all that apply below:

Sample Storage:

Refrigerate upon arrival

Store at room temperature

Store frozen

Light sensitive

Other:

Preliminary results:
Fax preliminary results	Email preliminary results	Phone preliminary results

SPSmedical Supply Corp. • 6789 W Henrietta Road • Rush, NY 14543 • (585) 359-0130 • (800) 722-1529 • Fax: (585) 359-0167