Collaborative Antiviral Testing group

Compound submission form

Submitter Name:

Submitter Compound ID:

Previously used Compound ID(s):

ARB #:

Compound Name:

RESUPPLY?
YES   NO

Structure:

Molecular Wt.:

Molecular Formula:

Stability:

Soluble in DMSO?  yes  no  warm

Hygroscopic/Deliquescent?

If no above, recommended solvent:

Single Compound (solid or liquid)?

Sample Qty:               (mg):

Compound(s) in Solution?

Concentration:            (mg/mL) Qty:         (mL)

Color:

Physical State:

Special safety/handling storage requirements:

Select virus(es) to be considered for screening:

Herpesviruses