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MicroED Sample Submission Form

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Date: *

Month

Day

Year

First Name: *

Last Name: *

Email: *

Telephone number: *

Institution: *

Department: *

Name of supervisor (If Applicable): *

Sample Information:

Sample name: *

Approximate crystal size (nm-μm): *

Chemical class/description: *

Molecular weight (if known):

Number of samples submitted: *

Sample concentration: *

Number of data collections requested per sample: *

Brief description of requested service and/or specific parameters (if applicable): *

Sample form:

Powder:

Suspension:

Pre-mounted TEM grid:

Hazardous? If so, Toxic, Biohazardous, Radioactive?:

Notes:

• Recommended crystal size: 50–200 nm. Larger crystals may be mechanically reduced prior to grid preparation if necessary.

• Preparation and imaging of up to 12 samples can be requested per submission.

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