IVF Workstation Application Questionnaire

The key to a successful Esco New Equipment purchase is to have our engineers initiate the project in the right direction. This happens with the Custom Request Form or Project Questionnaire.
The questions that are asked on the form are critical aspects for all applications. You can help Esco by being prepared to answer the questions on the form. With all the information your proposal, purchase, delivery and installation of your new Esco equipment will be more timely and accurate because of the care taken to start on the right foot.

* Denotes required fields for this form.
Section I: About Your Company
Your Name *
Company Name *
Telephone Number and Extension *
Fax Number
Email Address *
Section II: Workstation
Workstation Width Required *	Esco Standard 1.2m/4' (Internal Width) Custom, Specify: mm
Section III: Microscope
Oocyte pick-up, embryo handling and micromanipulation require various types of microscopes. Most common models of stereo zoom microscopes, transmitted light sources and inverted microscopes can be integrated into Esco IVF Workstations. These are different types of microscopes used for various IVF applications: a. Upright microscope - sperm vitality tests and ova collections. b. Inverted microscope - use with micro-manipulator for processes such as IXCI, IMSI. c. Stereo microscope - ova selection, pre-treatment of ova by means of IVF techniques and for manipulation.
Is a Built-In Microscope Desired?	Yes No
If Yes, Furnish Following Details	a. Supply Mode: Customer Supplied Existing Microscope Purchased and Built-In by Esco b. Manufacturer: c. Model, Item Code, or Part Number: d. Please Attach Microscope Datasheet, Mechanical Drawing(s) if Available : e. Desired Mounting Position: Left Centre Right
Section IV: Heated Light Stage
Ensures more accurate and reliable thermal control of specimens during observation under the microscope. Warming blocks must not be used on the heated glass stage. This will damage the heated glass stage.
Is a Heated Light Stage Desired?	Yes No
Section V: Heated Work Surface
If Custom Heater Patterns Required, Provide Drawing (If not, Esco will propose a heater layout.)
Section VI: Options and Accessories
Warming Blocks (State Tube/Plate Type)	60mm culture dishes 4-well(NUNC) culture dish 12 tubes (12mm) 3037 Dish 10 tubes (17mm) 7 follicular tubes (17mm) 5 flushing media syringes Custom Designs Available
Is Built-In LCD Screen Desired?	No Yes, Left Yes, Centre Yes, Right
Is Hydraulic Height Adjustable Stand Desired?	Yes No
Is Integrated Personal CO2 Incubator Desired?	No Yes, Location
Captcha *
(If Required, We'll Provide Proposal for Travel Cost and Daily Rate)