test page - GIG® Gluten Intolerance Group®

Phone
This field is for validation purposes and should be left unchanged.
Plant Name*
Name of the plant where the testing was performed
Plant Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Name*
This is who will receive the final report from GFCO.
First Last
Contact Email*
First Sample. Results from each pouch can be entered in any order.
Sample ID*
Test Kit Used*
Please select which test kit was used for testing this sample. Click on the box to see a drop down menu. If not listed, please select "other" and indicate the test name on the line below these choices.
"Other" Kit Used
Please only complete this field if "other" was selected as the test kit used for this sample.
Test Kit Part / Order Number*
Test Kit Supplier*
Test Kit Limit of Detection/Quantitation*
For qualitative/rapid kits, enter the gluten ppm detection level of the kit – for some kits, you may have the option to choose different detection levels, so please enter the level you used for this test. For quantitative/exact ppm tests, enter the value of the lowest positive (non-zero) kit standard – please make sure to include the units of measurement for that standard (e.g., ppm gluten, ppb gliadin, etc.).
Test Kit Lot Number*
Test Kit Expiration Date*
MM slash DD slash YYYY
Amount / Weight of Sample Tested*
- 0.2 g
- .25 g
- .5 g
- 1 g
- 1 spoonful using test kit spoon
- 2 spoonfuls using test kit spoon
- Other
If "Other" amount / weight of sample selected, indicate amount/weight here.
Did You Make Any Modifications to the Kit Protocol?*
- Yes (please explain in detail below)
- No
If Modifications to Kit Protocol, Please Describe Changes in Detail
Test Result for First Sample
- Less than 5 ppm (negative)
- Less than 10 ppm (negative)
- Greater than 5 ppm (positive)
- Greater than 10 ppm (positive)
- Exact gluten ppm value (if you choose this option, a field will display for you to enter your result)
Please enter the gluten ppm value for this sample below*
Enter the exact ppm value of the sample. This value must be expressed as ppm gluten. For kits that detect gliadin, refer to the kit instruction manual to determine how to convert your results into ppm gluten values. You may also enter values as less than or greater than the kit standard curve, for example <5 ppm or >80 ppm gluten.
Second Sample. Results from each pouch can be entered in any order.
Sample ID*
Test Kit Used*
Please select which test kit was used for testing this sample. Click on the box to see a drop down menu. If not listed, please select "other" and indicate the test name on the line below these choices.
"Other" Kit Used
Please only complete this field if "other" was selected as the test kit used for this sample.
Test Kit Part / Order Number*
Test Kit Supplier*
Test Kit Limit of Detection/Quantitation*
For qualitative/rapid kits, enter the gluten ppm detection level of the kit – for some kits, you may have the option to choose different detection levels, so please enter the level you used for this test. For quantitative/exact ppm tests, enter the value of the lowest positive (non-zero) kit standard – please make sure to include the units of measurement for that standard (e.g., ppm gluten, ppb gliadin, etc.).
Test Kit Lot Number*
Test Kit Expiration Date*
MM slash DD slash YYYY
Amount / Weight of Sample Tested*
- 0.2 g
- .25 g
- .5 g
- 1 g
- 1 spoonful using test kit spoon
- 2 spoonfuls using test kit spoon
- Other
If "Other" amount / weight of sample selected, indicate amount/weight here.
Did You Make Any Modifications to the Kit Protocol?*
- Yes (please explain in detail below)
- No
If Modifications to Kit Protocol, Please Describe Changes in Detail
Test Result for Second Sample
- Less than 5 ppm (negative)
- Less than 10 ppm (negative)
- Greater than 5 ppm (positive)
- Greater than 10 ppm (positive)
- Exact gluten ppm value (if you choose this option, a field will display for you to enter your result)
Please enter the gluten ppm value for this sample below*
Enter the exact ppm value of the sample. This value must be expressed as ppm gluten. For kits that detect gliadin, refer to the kit instruction manual to determine how to convert your results into ppm gluten values. You may also enter values as less than or greater than the kit standard curve, for example <5 ppm or >80 ppm gluten.
Third Sample. Results from each pouch can be entered in any order.
Sample ID*
Test Kit Used*
Please select which test kit was used for testing this sample. Click on the box to see a drop down menu. If not listed, please select "other" and indicate the test name on the line below these choices.
"Other" Kit Used
Please only complete this field if "other" was selected as the test kit used for this sample.
Test Kit Part / Order Number*
Test Kit Supplier*
Test Kit Limit of Detection/Quantitation*
For qualitative/rapid kits, enter the gluten ppm detection level of the kit – for some kits, you may have the option to choose different detection levels, so please enter the level you used for this test. For quantitative/exact ppm tests, enter the value of the lowest positive (non-zero) kit standard – please make sure to include the units of measurement for that standard (e.g., ppm gluten, ppb gliadin, etc.).
Test Kit Lot Number*
Test Kit Expiration Date*
MM slash DD slash YYYY
Amount / Weight of Sample Tested*
- 0.2 g
- .25 g
- .5 g
- 1 g
- 1 spoonful using test kit spoon
- 2 spoonfuls using test kit spoon
- Other
If "Other" amount / weight of sample selected, indicate amount/weight here.
Did You Make Any Modifications to the Kit Protocol?*
- Yes (please explain in detail below)
- No
If Modifications to Kit Protocol, Please Describe Changes in Detail
Test Result for Third Sample
- Less than 5 ppm (negative)
- Less than 10 ppm (negative)
- Greater than 5 ppm (positive)
- Greater than 10 ppm (positive)
- Exact gluten ppm value (if you choose this option, a field will display for you to enter your result)
Please enter the gluten ppm value for this sample below*
Enter the exact ppm value of the sample. This value must be expressed as ppm gluten. For kits that detect gliadin, refer to the kit instruction manual to determine how to convert your results into ppm gluten values. You may also enter values as less than or greater than the kit standard curve, for example <5 ppm or >80 ppm gluten.
Please review your information for accuracy. Changes can not be made after you hit "Submit".

GFCO Proficiency Results

First Sample. Results from each pouch can be entered in any order.

Second Sample. Results from each pouch can be entered in any order.

Third Sample. Results from each pouch can be entered in any order.

Please review your information for accuracy. Changes can not be made after you hit "Submit".