Service Inquiery Form

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Name *

First

Last

Email *

Company / Institution Name: *

Enter ‘Personal’ if this is personally owned equipment.

Type of Microscope:

Stereo (aka Surgical)
Compound (multiple objective lenses)

Select one.

Number of Objective Lenses (if compound):

Microscope Form:

Upright (objective lenses point down)
Inverted (objective lenses point up)

Select one.

Microscope Ocular Type:

Monocular (one eyepiece)
Binocular (two eyepieces)
Trinocular (two + camera port)

Select one.

Details:

LED light source
Stage Clips
Mechanical Stage (Slide is moved with knobs)

Check all that apply.

Details – be as specific as possible.

If you have multiple microscopes please answer the above questions that reflect the majority of your models – and add the number of units, make and models here in the details.

I can be without my microscope for ___ business days as it is serviced:

14+
7+
4 (standard)
2 (‘expidited’ premium added to invoice)
1 (‘rush’ premium added to invoice)
Overnight / Over Weekend (’emergency’ premium added to invoice)

Select one.

I might need a replacement (rental) microscope for the duration of the service.

Yes
No

Select one.