Decontamination Form

It is the policy of Andor Technology to protect the Health and Safety of our employees and to provide a safe working environment. In support of this stance Andor Technology requires that all products returned from customers be uncontaminated from harmful substances, which the equipment may have been exposed to during its use/application.

Completion of this form is a declaration that the equipment is contamination free, and is safe for Andor employees to work on.

Any products returned to Andor Technology without this completed form will not be processed.

Name *

Organization *

Telephone *

Email *

Position Held *

Date *

Product *

Serial Number *

RMA Number *

RMA Return Address

Has this equipment been exposed to any of the following

Bio Hazardous Material

Hazardous Chemicals

Radioactive Material

Other Infectious/Hazardous Materials

Not Applicable

Where the equipment to be returned has been exposed to any of the above please indicate how it has been decontaminated and any checks which have been made to confirm that it is contamination free.

By submitting this form I agree that Oxford Instruments will process my data in the manner described in the Privacy Policy

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