Name: {{ profile.first_name }} {{ profile.last_name }} Email: {{ profile.email }} Lab: {{ profile.laboratory }} Company: {{ profile.company }} Address: {{ profile.address_1 }} {% if profile.address_2 %} {{ profile.address_2 }} {% endif %} {{ profile.city }}, {{ profile.state }} {{ profile.zipcode }} {{ profile.country.display_name }} Phone: {{ profile.phone }} {% if profile.ap_email %} Accounts Payable Email: {{profile.ap_email}} {% endif %} Send back processed blocks/slides?: {{ "Yes" if profile.sample_return_requested else "No" }} Generate Fedex shipping label?: {{ "Yes" if profile.generate_shipping_label else "No" }} Fedex/UPS Shipping #: {{ profile.shipping_no }} How did you hear about us? {{profile.get_referer_type_name()}} {% if profile.referer_detail %} ({{profile.referer_detail}}) {% endif %}