Rental Request Form


Please note this is a request for rental equipment only. We will confirm your order once we have verified availability of stock. We will endeavour to respond to your request within 3 hours. You can always contact us on 1300 735 295 or RentalsAU@thermofisher.com

Order Contact Details:


First Name:  *
 
Phone:  *
 
Last Name:  *
 
Mobile Phone:
Company Name:  *
 
Email Address:  *
   
Company Address:    *
 

Rental details:

Delivery\Required Rental Date:    *
Rental begins from this date
 
Time:
Rental Return Date:  *
 
Delivery Address:
(if different to Company Address)
Project Reference Number :

Application Details (optional)



Equipment Required


Click the Add button after each category/product/qty selection. Then repeat as necessary.
When your order is complete, click Submit button.

Category:    
Product:  
Quantity:  *    



   


Click here to view Rental Terms and Conditions

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