Survey Meter Loaner Request

Loaner survey meters are only provided to clients whose meters are calibrated annually by QAS and are dependent on current availability.

To request a loaner meter, please fill out the form below.

Borrower Contact Information

First Name

Last Name

Facility Name

Multi-line address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Phone

Special Requests or Instructions

Billing Contact Information

Same as above.

First Name (Billing)

Last Name (Billing)

Phone (Billing)

Email (Billing)

Borrower Responsibility Attestation

Please read carefully and sign below to acknowledge:

The Borrower is responsible for any loss, theft, or damage to the Equipment occurring while it is in the Borrower's possession. The Borrower agrees to reimburse the Lender (Quality Assurance Services, Inc.) for the reasonable cost of repair or replacement if the Equipment is not returned in the same condition as it was shipped by the Lender.

Borrower Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Before shipping your survey meter to QAS for calibration, please print, fill out, and send the Calibration Authorization Form below with your meter.

Click to Download:

Calibration Authorization Form.pdf