Demande de service

Veuillez remplir le formulaire ci-après - quelques informations seulement sont nécessaires.

Une fois que vous aurez saisi votre adresse et quelques données clés de votre unité, veuillez ensuite décrire votre demande.
Les champs marqués d'une * sont obligatoires !
De plus, ce formulaire vous donne la possibilité de joindre un maximum de trois fichiers aux formats *.pdf et *.jpg (par ex. enregistrements de processus ou photos) et d'une taille maximale de 5 Mo par fichier. Ceci nous aidera à analyser votre problème ou à identifier des composants de votre unité et, ainsi, à accélérer le traitement de votre demande.

Type of Request

Service Request

Spare Parts Order

Request for Technical Information

Maintenance contract available

Address

Company*

Institute*

Title*

First name*

Last name*

Street/no.*

Zip/City*

Department

Workgroup

Customer no.

Phone*

Fax*

Email*

Country*

Contact Person / Responsible for Machine

Title*

First name*

Last name*

Building

Telephone*

Fax

e-Mail*

Floor

Room

Customer Order No. (optional)

Order no.

Date

Unit Data (see name plate)

Type*

IVD*

In Vitro Diagnostics

Serial/ fabrication no.*

Controller

Year of manufacture*

Location*

Security area*

Attachments

Detailled description and additional notes where necessery*

This form provides the possibility to append .pdf or .jpg files (max. 5 MB each, e.g. process documentation files or photographs). This will help to analyze your problems or identify parts of the unit. Please use the buttons below to choose the files.

File Attachments

I read the Privacy Terms and agree.*

The * tagged input fields are mandatory! After pressing »Submit«, maybe an input field is displayed with red background. In this case please check your input and press »Submit« again. A shipping notice will be displayed and a copy og your message will be sent to your email address.

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