X-Ray Inspection Request Form
Submit your request for X-ray inspection of items or materials. Please provide complete information to ensure accurate and timely processing.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Company or Department
Item or Material Name
*
Item Type
*
Please Select
Metal Component
Electronic Assembly
Welded Part
Casting
Plastic Part
Other
Quantity to Inspect
*
Serial or Batch Number
Type of X-Ray Inspection
*
2D Radiography
3D Computed Tomography (CT)
Real-Time Inspection
Other
Purpose of Inspection
*
Quality Control
Failure Analysis
Regulatory Compliance
Research & Development
Other
Preferred Inspection Date & Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Special Instructions or Notes
Upload Supporting Documents (drawings, specifications, etc.)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Signature (Confirming the accuracy of the provided information)
*
Submit Request
Submit Request
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