QED RAC Request

QED RAC Repair / Calibration Request
Service Request Type*

Billing Info
Company Name*
Site Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Shipping Info
Same As Billing

Yes
Company Name (Ship)*
Site Name (Ship)
Ship To Name

First Name Last Name
Address (Ship)*

Street Address

Street Address Line 2

City State

Zip Code

Contact Info
Name*

First Name Last Name
Company Name*
Email*
example@example.com
Office Phone
Mobile Phone

Equipment For Service
Maximum of 5 devices are allowed on each return request.
Device #1 Model
Device #1 Serial #
Device #2 Model
Device #2 Serial #
Device #3 Model
Device #3 Serial #
Device #4 Model
Device #4 Serial #
Device #5 Model
Device #5 Serial #

ViaSensor Analyzer Information
Analyzer Model
Serial #
Reason*
IMPORTANT: * Send USB Cable, Battery Charger or Temperature Probe if needed for repair or additional inspection.

Note: QED will contact you with an RA number and shipping instructions within 24 hours of your submittal.

Landtec Analyzer Information
Analyzer Model
Serial #
Reason*
IMPORTANT: Remember to save/download all readings and ID’s prior to sending in your instrument. Please specify if you would like us to save and email them to you. All instruments will have the memory wiped prior to shipment. * Send USB Cable, Battery Charger or Temperature Probe if needed for repair or additional inspection.

Terms and Submit
Do You Have A PO?*
PO #*
Attach PO #

Browse Files

Cancelof
Should we proceed with the repair/calibration using the PO provided above, or would you like us to send you a quote/estimate first?
How To Process w/ PO*
Additional Information

0/50
QED will contact you within 24 hours of your submittal.
Please verify that you are human*
Should be Empty: