PCB X-Ray Inspection Request Form
Submit your PCB inspection request with the board details, inspection scope, supporting files, and logistics information needed to begin the X-ray review.
Requester and Company Information
Requester Full Name
*
First Name
Middle Name
Last Name
Job Title / Role
*
Company Name
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department or Team
Secondary Contact Name
First Name
Middle Name
Last Name
Secondary Contact Email
example@example.com
Secondary Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
PCB and Project Identification
PCB or Project Name / ID
*
Board Revision
Assembly Part Number or SKU
Number of Boards to Inspect
*
Project Description or Reason for Inspection
*
Inspection Request Details
Inspection Purpose
*
First article verification
Suspected defect investigation
Process validation
Incoming inspection
Sample review
Other
Areas to Inspect
*
Components
Solder joints
Vias
Internal layers
Hidden joints
BGA/QFN areas
Other
Desired Inspection Depth
*
Please Select
Overview
Standard
Detailed
High-resolution imaging
Specific Failure Symptoms or Questions for the Lab
Files, Packaging, and Logistics
Supporting Files
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Board Delivery Method
*
To be shipped in
Already on-site
Pickup required
Requested Turnaround
*
Please Select
Standard
Expedited
Rush
Specify due date
Due Date
 -
Month
 -
Day
Year
Date
Return Shipping Instructions / Destination
Submit Request
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