退货授权 | Prior Scientific 

Step 1 / Product & fault information

Brand*:

Prior Scientific

Queensgate

Product/Model Number*:

Serial Number:

What is the fault?*

Additional information

If you have any additional information please complete the following fields to help us with processing your RMA request:

Purchase Order Number:

Sales Order Number:

Prior Scientific contact/Sales contact:

Invoice Number:

Software Used, Version Number:

Date of Purchase:

Please add any images of equipment that may help us diagnose the problem. Max 4 files. (When uploading multiple images, remember to hold down the Ctrl key while selecting them.)

Upload Images

Step 3 / Declaration & Shipping / Billing

‘Safe to handle’ declaration

By ticking the below box you are declaring the following:

You are a competent person who has knowledge of the substances used with the equipment
You have made reasonable inquiry as to the substances in contact with the equipment
The information given is accurate and no information has been withheld
The decontamination methods are in accordance with your own health and safety procedures
All surfaces of the equipment are safe to touch

I hereby declare that the equipment due to be returned to Prior Scientific is safe to handle*

Signatory’s name

If you have followed the decontamination guidance but believe there may be contaminants or other substances in inaccessible areas (e.g. between stage plates) please tick here.
Ticking below does not invalidate the safe-to-handle declaration.

Please indicate below for any additional handling instructions – for example, if protective equipment is required, in case of any inaccessible contamination.

Shipping & Billing Information

Equipment being returned to Prior Scientific must be in its original protective packaging, and Prior will not be responsible for any damage incurred during transit. If you no longer have the original packaging, please contact us for a quote. Equipment returned without its original packaging will incur a packaging charge to ensure the safe return shipment of the product after repair.

Shipping Address

Company

First Name*

Surname*

Email*

Telephone*

Street Address

Street Address Line 2

City

State / Province / Region

ZIP / Postal Code*

Country

Please check if billing address is different from shipping address

I have read and agree to the privacy policy.*

Billing Address

This is the address and contact for any correspondence relating to charges incurred for during the RMA process. Distributor details should be entered here where equipment is under service contract/warranty and is being shipped directly between Prior Scientific and the owner of the equipment

Return Merchandise Authorization Request

Step 1 / Product & fault information

Brand*:

Product/Model Number*:

Serial Number:

What is the fault?*

Additional information

Purchase Order Number:

Sales Order Number:

Prior Scientific contact/Sales contact:

Invoice Number:

Software Used, Version Number:

Date of Purchase:

Step 2 / Decontamination Information

RMA Decontamination Guidance Download

Has the equipment been used?

Please provide details of substances used with the equipment. One entry per substance:

Substance name*

Are there any substances that may combine/react with it to form a dangerous mixture? Please give details.* (Enter N/A if not applicable.)

What method of decontamination was used?* (Enter N/A if not applicable.)

Step 3 / Declaration & Shipping / Billing

‘Safe to handle’ declaration

Signatory’s name

Please indicate below for any additional handling instructions – for example, if protective equipment is required, in case of any inaccessible contamination.

Shipping & Billing Information

Shipping Address

Company

First Name*

Surname*

Email*

Telephone*

Street Address

Street Address Line 2

City

State / Province / Region

ZIP / Postal Code*

Country

Billing Address

Company

First Name

Surname

Email

Telephone

Street Address

Street Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

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