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Many analyzer issues can be resolved without being returned by talking with one of our Service Engineers.  Please contact us prior to filling out this form.  If you still need to return your analyzer, please complete the following form.  Providing complete and accurate information about your product return request will help us to meet your expectations. Please read the terms on returns of instruments and parts.

 

  
 

(*) Indicates Required Field


Company Name*
Contact Name*
Email Address*
Phone Number*
Customer PO#


Should we have technical questions regarding the analyzer, to whom should we direct our questions?

Tech Name
Tech Phone
Tech Email


Please enter product details.

Serial Number*
Model or Description*
Reason for Request of RGA / Detailed Description of Problem*


To ensure the safety of our employees please check the box and fill in the information as needed that describes your equipment for return. Any instruments found with unknown contaminants will be quarantined until the issue is resolved.

This Piece of equipment has been decontaminated. It is free from Chemical, Biological or Radioactive contamination and is safe to handle without special handling precautions.

This Piece of equipment has not been decontaminated. It is free from biological or radioactive contamination, but has been exposed to chemicals that require special handling procedures. Please list the significant components.

This Piece of equipment has not been decontaminated and is safe
to handle without special precautions. Please list the significant components.

Please enter your billing and shipping details.

Billing Information
Company*
Contact Name*
Billing Address*
 
 
City*
State*
ZIP*
Country*

Shipping Information
Company*
Contact Name*
Shipping Address*
 
 
City*
State*
ZIP*
Country*

Preferred Shipping Method for Return of Instrumentation
Shipping Method*
Required Delivery*
Shipping Terms*
Customer's Shipping Account Number*
Additional Comments/Notes
Enter the characters above



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