Welcome to the Pipette Lead Exchange Program

Welcome to the Pipette Lead Exchange Program. Any pipette beyond economical repair is in the scope of this program.

Fields marked with an * are required.

Your Contact Details
Your First Name *
Your Last Name *
Your Email Address *
Your Phone Number *
Your Office and Business Unit:
 

Customer Details

 
Company Name *
Customer Title
Customer First Name *
Customer Last Name *
Customer Contact Phone *
Customer Address Line 1 *
Customer Address Line 2
Building/Department
Customer City *
Customer Country *
Customer ZIP/Postal Code *
Customer Email Address *
 

Pipette Lead Details
Brand:
 *
Serial Number: *
Type of Pipette: *
Number of channel(s): *
Defect on current pipette: *
Price the repair would be quoted: *
Comments: (Please include any additional customer information, application, etc)
Please check this box if the customer must be contacted within 1 working day.