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BIZKAIA CENTRAL ANALISIS SERVICE REQUEST, GENERAL DATA

Request sheet

(*)Mandatory fields to complete.

 

 

Applicant data

 

Applicant data
Name(*): Last names(*):
Phone/extension(*): e-mail(*):

 

Billing data

Billing data

 

UPV/EHU user External user

 

Department(*):
Main researcher(*):
Project title(*):
Financing organism(*):
If you want the principal investigator or project manager to receive a copy of this application, you can specify his email here Main researcher e-mail:

Research group(*):


Organic(*):

Functional(*): 21 24 25 26 others
I Know and accept the access protocol and the rate applied for services, depending on current rates or budget accepted.

 

In accordance with Article 5 of Law 15/1999 of 13 December on the Protection of Personal Data, we inform you that your data becomes part of the file "Research Management"in the UPV Country, whose purpose is the administration of Vice President for Research at the UPV / EHU. We inform you that you can exercise your rights of access, rectification, cancellation and opposition of their data by sending a letter to the person in charge of security LOPD UPV / EHU, Rector, Barrio Sarriena s / n, 48940 Leioa, Bizkaia, enclosing a copy of document proving their identity. You can view the "Regulations of the UPV / EHU for the Protection of Personal Data" in Internet addresses www.ehu.es/babestu.

 

Results (*)

  • Along with your analisis it will be delivered a Results Report free of charge.

  • It is also possible to order a Technical Report of Results. This report has an additional cost which you can consult in this web page.


YES, I WANT A Results Technical Report of Results  

 

Post sample treatment

We reminds users of the Service that the samples should be collected after delivery and notification of the report. If the samples are not collected they will be removed for disposal in 15 days. If the user want to retrieve the samples, must notify the Service to collect them before the expiration of the deadline

 

I wish to recover the sample after its analisis.

 

I wish and accept to receive the report of results thru unencrypted email.
I wish to receive the report of results in paper.