Intake Intake Form Intake Form "*" indicates required fields Name / Company name Phone Number with Area Code Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Strain InformationStrain Sample ID Matrix Type Sample Size Batch Produced Collected Received MM slash DD slash YYYY Completed MM slash DD slash YYYY Batch#SummaryBatchBatch Date Tested* MM slash DD slash YYYY Batch Result*SelectPassFailCannabinoidsCannabinoids Date* MM slash DD slash YYYY Cannabinoids Result*SelectPassFailMoistureMoisture Date* MM slash DD slash YYYY Moisture Result*SelectNT - Not TestedNR - CompleteWater ActivityWater Activity Result*SelectNT - Not TestedNR - CompleteForeign MatterForeign Matter Result*SelectNT - Not TestedNR - Complete Δ
