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LAB & INDUSTRY EQUIPMENT

 
 

SERVICE FORM

To create a new service case, please fill out the form below. You have the option to attach pictures or other files that are relevant to the case. Once we have received the form, you will be contacted by the technician, responsible for the matter, as soon as possible. If service is to be done at our workshop, the completed form must be printed out and sent with the item.

Important: If the form is not shipped with the product, service will not be performed in our warehouse from our service staff. You will receive the form as a PDF file in your email.

If you have any questions, feel free to contact Kristine Povelsen at the phone number +45 44 54 00 26 or by e-mail at kp@buch-holm.dk.

*required fields

 
 
Full name*
 
 
 
E-mail address *
 
 
 
Company name*
 
 
 
 
Department
 
 
 
Street name and number*
 
 
 
City*
 
 
 
Postal / Zip code*
 
 
 
Telephone number*
 
 
 
 
 
EAN number
 
 
 
Requisition number
 
 
 
Which device needs service?*
 
 
 
Model/Type
 
 
 
 
Serial number S/N*
 
 
 
Has the equipment been in contact with dangerous substances?*
 
Yes
No
 
 
 
If yes, which?
 
 
 
Is the appliance cleaned/decontaminated?*
 
Yes
No
 
 
 
If no, why not?
 
 
 
Should any environmental considerations be taken?*
 
Yes
No
 
 
 
If yes, which?
 
 
 
Description of problem
 
 
 
Where do you wish for the repair to take place?*
 
At Buch & Holm
At our address (address has to be filled)
 
 
 
Service - Street name and number
 
 
 
Service - City
 
 
 
Service - Postal/Zip code
 
 
 
Further comments
 
 
 
 
Upload files (if any)