NIMH Chemical Synthesis and Drug Supply Program

Order Form

Instructions: Fill out the form completely and press the "order now" button.

1. Compound Requested:
MH No.:
Chemical Name:
Amount:

2. Brief description of the intended use and importance of research to neuroscience:

3. Description of protocol to be used, including detailed justification on the requested amount.
(See Ordering Information for instructions.):

4. Literature citations regarding the requested compound or related compounds.:

5. Primary source of funding for the proposed research
(Provide grant number if the funding source is NIH):

6. Publications resulting from the inventory compounds:

7. Name of scientist requesting compound(s):

8. Shipping address:	9. Mailing address (if different than 8.):

10. Telephone/Fax numbers:

11. Email address:

About The Program

Since 1959, the NIMH Chemical Synthesis and Drug Supply Program has synthesized and distributed novel research chemicals, psychoactive drugs, and compounds that are unavailable from commercial sources to the scientific community working on research relevant to mental health.

NIMH Chemical Synthesis and Drug Supply Program

Order Form

About The Program

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