Septa, caps and liners - custom request form

Please enter your contact information and select the appropriate product specifications required. Once your request is submitted, a customer service representative will contact you within the next 1-2 business days.

• First Name *
• Last Name *
• Email *
• Phone Number *
• Cap size in mm
  - Select a Value - 8 mm 9 mm 10 mm 11 mm 13 mm 15 mm 18 mm 20 mm 24 mm Other
• Cap type
  - Select a Value - Screw Snap Crimp Other
• Cap color
  - Select a Value - Black Blue/Royal blue Red Green Yellow Silver Gold Other
• Liner material
  - Select a Value - Silicone Viton Butyl Other
• Liner color
  - Select a Value - White Tan Natural/Virgin Red Blue/Royal blue Other
• Liner thickness in mm
• Film material
  - Select a Value - None PTFE FEP Polyimide Other
• Film color
  - Select a Value - None Red Blue/Royal blue White Tan Other
• Septa diameter in mm
• Slit type
  - Select a Value - Non slit Straight slit Cross slit Other
• Comments (please provide details for any other custom requirements)
• I’d like to receive relevant updates from you

Submit