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Service Work Order Request

If our Technical Assistance Center (TAC) recommended an In-house Repair, please complete the Service Work Order request.

Service Work Order Request

Sender

Customer

Product(s) Enclosed:

If returning more than one item for repair, please submit a separate request for each item.

Detailed Description of Problem

Product Environment / Background

Please be as specific as possible:

Service Requested

Decontamination Declaration

Safety level of the Lab the Item was returned.
The Item / Equipment listed above has come in contact with:
Decontaminated with: *
Isotope(s): *
Additional Notes (if applicable):
Decontaminated with: *
Specifications: *
GHS / SDS Statement: *
Additional Notes (if applicable):
Decontaminated with: *
Specifications: *
GHS / SDS Statement: *
Additional Notes (if applicable):
Decontaminated with: *
Specifications: *
GHS / SDS Statement: *
Additional Notes (if applicable):

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