JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Application for laboratory facilities
Please fill out this application to request the use of the Dept. of Medical Laboratory Sciences laboratory facilities. We will respond as soon as possible.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name of applicant.
*
Your answer
Designation of applicant.
*
Your answer
Institute of the applicant.
*
Your answer
The contact number of the applicant.
*
Your answer
Purpose for requesting laboratory facilities.
Research
Diagnostic
Other:
Clear selection
Please mention the approximate dates and time durations that you will require the facilities.
Your answer
Please check the box for the instrument/s you intend to use.
Column 1
Elisa Reader
Elisa Plate Incubator+ shaker
Gel Electrophoresis Unit
PCR Unit
Gel Documentation Unit
Refrigerated Micro Centrifuge
Microtome
Tissue Processor
Paraffin Oven
Fully Automated Bio Chemistry Analyser
Bio Safety Cabinet
Uv-Vis Spectrophotometer
Centrifuge
Coagulation Analyser
Flame Photometer
Autoclave
Haematology Analyser
Deionize water Plant
Water Bath
Incubator
Microscopes
Column 1
Elisa Reader
Elisa Plate Incubator+ shaker
Gel Electrophoresis Unit
PCR Unit
Gel Documentation Unit
Refrigerated Micro Centrifuge
Microtome
Tissue Processor
Paraffin Oven
Fully Automated Bio Chemistry Analyser
Bio Safety Cabinet
Uv-Vis Spectrophotometer
Centrifuge
Coagulation Analyser
Flame Photometer
Autoclave
Haematology Analyser
Deionize water Plant
Water Bath
Incubator
Microscopes
Please specify any other requests or queries.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Open University of Sri Lanka (OUSL).
Does this form look suspicious?
Report
Forms