InduSol America - Request Service Technician

Company Name*
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Your Department / Function
Plant Name or Designation
Facility Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country*
What service is required?*

TroubleshootingCondition AnalysisCommissioningInitial MeasurementRevision MeasurementOther
If selecting "Other", please describe the issue:
Which network system does the service refer to?*

PROFIBUS DPASiPROFIBUS PACANPROFINETDeviceNetEtherCATEtherNet/IPIndustrial EthernetFiber OpticShielding/Equipotential Bonding (EMC)Industrial WiFiSafetyBUSInterbusOther
If selecting "Other", which protocol(s) are you using?
Is it possible to provide us with documents, e.g. topology plan, plant layout, specification, etc.?*
Mandatory in order to provide you with a suitable quotation. (permitted formats .jpg, .pdf, .excel)
When shall the service take place?*

as soon as possible (within 7 working days)within 2-4 weeksPreferred period (specify below)
Do you have a preferred date(s)?
Anything else we need to know?
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Please verify that you are human*
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