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Maxwell Instrument Please Enquire Form

Use this form to request pricing, or to try a Maxprep™ or Maxwell® System in your lab. We will contact you within 1-2 days of your submission to provide a quote or arrange a demo.

MS-2021-Maxwell Instrument Request Form
Which instrument would you like pricing information for?*
 
 
 
 
 
 
Are you interested in an instrument demo?*
 
Yes
No
 
 
 
 
 
What type of targets does your lab purify? (please check all that apply) 
 
Genomic DNA
 
 
Total RNA
 
 
 
Polyhistidine or HQ Proteins
 
 
Viral Total Nucleic Acid
 
 
 
Plant DNA/RNA
 
 
DNA From Raw or Processed Foods
 
 
 
ccfDNA
 
 
miRNA
 
 
 
Other
 
 
 
 
If other, please specify?
 
 
 
 
 
 
What sample types do you use?
 
 
 
 
 
 
What type of research are you performing?
 
 
 
 
 
 
First Name*
 
 
Last Name*
 
 
 
Email*
 
 
 
Company/Institute*
 
 
Department*
 
 
 
Building/Room/Lab*
 
 
 
Street Address*
 
 
 
City*
 
 
State/Province/Region (If applicable)*
 
 
 
Postal/Zip Code*
 
 
Country - Full List*
 
 
 
Phone
 
 
 
 
 
 
How would you like to be contacted*
 
Phone
Email
 
 
 
 
 
I want to receive e-mails about new products and technologies, promotions, webinars and events. (Optional)
 
 
 
I have read and agree to the Promega Guidelines for Processing Personal Information (see link below)*
 
 
 
Promega Guidelines for Processing Personal Information

Products may not be available in all countries. After completing this form, we will contact you if the instrument you are inquiring is not unavailable in your country.