Microelectrode Array - Spike Neuro

Contact Person’s Name:

Contact Person’s Email:

Contact Person’s Telephone:

Institution Name:

Institution City and Country:

Principal Investigator’s Name

Name on Quote (if not contact person):

GENERAL SPECIFICATIONS

Layout

E = Epoxy length below connector.
L = Length of wire beyond epoxy.
Rs= Distance between rows.
Es= Distance between electrodes.

DESIGN SPECIFICATIONS

Metal type:

Include Polyimide jacketing? (recommended for long electrode lengths over 1cm

Include Polyimide tubing yes

Include Polyimide tubing other yes

Number of Electrodes

Electrode Impedance Value

PHYSICAL MEASUREMENTS

(L) Length of electrode beyond epoxy

other electrodes

(E) Epoxy length below connector

other electrodes (copy)

(Es) Distance between electrodes

(Es) Distance between electrodes others

(Rs) Distance between rows

other rows

Include a reference electrode/wire?

electrode/wire if Yes

electrode other

Include a Ground wire?

Select Metal type

type if selected

other

Number of rows

other

CONNECTOR AND HEADSTAGE

Connector(s), Please select one

Indicate desired connector

Provide us with the brand and model of your recording and/or stimulation system

RECORDING CHANNEL PINOUT

Layout

To ensure your complete satisfaction, MicroProbes for Life Science will provide a photograph and copy of the pin layout mapping and corresponding microelectrodes, including reference and ground, with your shipped order. Connector pin assignments will reflect connector pin numbers NOT headstage channel numbers

YOUR CUSTOM DESIGN AND LAYOUT SHEET

If your requested design cannot be fully described by the questions above, please attach a description here. Make drawing as clear as possible:

Upload a file:

Click or drag files to this area to upload. You can upload up to 5 files.

ACCESSORIES AND ADDITIONAL SERVICES

Do you require product pre-sterilization?

Yes
No

(Sterilization (ethylene oxide gas) will be performed by a third party and requires an additional fee to cover process, packaging, and shipping. Typical fee is $850 USD per batch. Process is not validated for human use.)

APPLICATION DESCRIPTION (OPTIONAL)

The following questions can help our sales team assist you in optimal probe selection and design

Animal Model / Application:

Implant Location / Usage Description:

Layout

Acute or Chronic Use:

Functionality

ABOUT YOUR ORDER

How many of this MEA design do you wish to order?

Delivery options

Standard 6 weeks delivery
Rush order

Special requirements

Microelectrode Array – MEA

GENERAL SPECIFICATIONS

DESIGN SPECIFICATIONS

PHYSICAL MEASUREMENTS

CONNECTOR AND HEADSTAGE

RECORDING CHANNEL PINOUT

YOUR CUSTOM DESIGN AND LAYOUT SHEET

ACCESSORIES AND ADDITIONAL SERVICES

APPLICATION DESCRIPTION (OPTIONAL)

ABOUT YOUR ORDER