Online Service Request

Online Service Request Logging Form

This form is intended for use by customers to request a new support call (Service Request). For urgent requests, status updates, preventive maintenance or cancelling a Service Request, please call:

Belgium: +32 2 404 92 22
Netherlands: +31 20 547 2600

Contact details for support on Vacuum Products (none-MS related), Raman Spectroscopy, ACEA, Pathology, Flow Cytometry and Airport Security/Handheld Chemical Detection can be found by following the link below:

If you do not have a support agreement with Agilent you can get an On Demand Repair Quote.

You can also find self help resources via the Agilent Community, Agilent Knowledge Portal or Agilent Education/University.

Please note - the information collected will only be used to facilitate the processing of your service call.

Despite the English form, we encourage filling in the form in your preferred Communication Language

Preferred communication language

Please select your preferred language for follow up communication

Technical & Fault/Service Details

This field is required

Model Number*

For Software requests type the name (e.g. OpenLab CDS, MassHunter). For genomics reagents, type the kit name and part number (e.g. Brilliant Multiplex QPCR Master Mix - 600553).

Serial Number*

If your request relates to software write the revision if known (e.g. C.01.01). If your request relates genomics reagents type the lot number.

Technique*

e.g ICPMS, LC, QPCR

Please select the Support Entitlement*

Fault Description and/or Service Requested*

Please provide as much detail as possible, this will help minimize potential delays.

Steps already taken-troubleshooting already performed*

The more detail the more likely we can identify the correct parts/action required and minimise downtime.

Is the system currently useable?

Customer Information - This should be the user of the Equipment

Alternate contacts make it easier for us to get in touch

Primary Contact First Name*

Primary Contact Last Name*

Work Telephone Number*

Secondary Phone Number

e.g mobile/lab

Email Address*

Alternate Contact First Name

Alternate Contact Last Name

Alternate Work Telephone Number

Alternate Telephone Number

e.g mobile/lab

Alternate Email Address

Customer Information - For scheduling purposes (leave blank if the same as the end user)

Primary Contact First Name

Primary Contact Last Name

Work Phone Number

Alternate Phone Number

e.g mobile/lab

Email Address

Instrument Location

Company Name*

Address 1*

Address 2

Building / Lab #

City*

County*

Postal Code*

Country*