Centro Interdipartimentale 
di Spettrometria di Massa 
Università degli Studi di Firenze

Sample requisition form

Date:    ……………….
Department:……………………………………………………………………………………………….
Group Leader:  Prof. / Dr.:  ………………………………………… e-mail:…………………..….......
Your name  …………………………………Tel.:  …………….…… e-mail:…………………..…......
Sample name  ..…………………………………………………………………………………………..
File Name:  ………………………………………………………………………………………………..
Concentration (if in solution) / Quantity (if solid)  ……………………………………………………..
Sample molecular weight  ………………………………………………………………………………
Dissolving Solvent1 ………………………………………………………………………………………
Comments on sample solubility and solvent compatibility2 …………………………………………
………………………………………………………………………………………………………….……………………………………………………………………………………………………………….
MS Analysis required:
ESI-MS    ESI-LC/MS    ESI-LC/MS/MS    MALDI/MS    MALDI/MS/MS   
HR-MS (High Resolution)   APCI    GC/MS     GC- MS/MS       EI        CI   

Sample structure and chemical formula ………………………………………………………………

1Solvent in which you have dissolved your sample
2Sensitive/Not sensitive to acids, solubile/not solubile in methanol (or Acetonitrile etc…), recommended dilution solvent for MS Analysis