Value Added Services (VAS) lead referral program for Instrument and Enterprise Services (IES)

Welcome to the internal lead referral program for Value Added Services supported by the Instrument and Enterprise Services organization.

Please use this webform to submit your leads for the relevant VAS products.

IMPORTANT NOTE: After you hit the submit button, you will receive an email notification including the details of the lead you submitted. Please note that, it may take up to 10 minutes after you click submit to receive the notification email. Once it appears your customer is interested, please coordinate with your sales partner and share any correspondence you have with the customer in advance of the first customer meeting.

* Fields marked with an asterisk must be completed.

Your Contact Details

Your Full Name: *

Your Email Address *
(*@thermofisher.com addresses only)

Your Phone Number *

Your Office & Business Unit: *

Customer Details

Company Name *

Customer Title *

Customer First Name *

Customer Last Name *

Customer Contact Phone *

Customer Address Line 1 *

Customer Address Line 2 *

Building/Department *

Customer City *

Country *

Customer State/Province *

Customer Zip/Postal Code *

Customer Email Address *
(*@thermofisher.com addresses not allowed)

Service Lead Details

Main product of interest *

Serial Number *

Comments:

(Maximum characters: 700)
You have characters left.

Optional Information

Qty of Labour Hours Needed

Travel Zone