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Olympus

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The form below is for registering your microscope. If you are registering your MIC-D Digital Microscope, please click here.

If you have already filled out and mailed your microscope registration card you do not need to use this form. The optional questionnaire that follows will help us to continually improve our Olympus microscopes, and we appreciate your feedback. If you are registering multiple microscopes, please fill out the entire form first and click submit. You will then be prompted to register the model and serial number for each additional microscope. Olympus


Mr. Mrs. Ms. Dr.
First Name:	M. Initial:	Last Name:
Company:		Title:
Address: (Number and Street)		Address 2:
City:		State:	Zip:
Phone Number: ( ) - -		Fax Number: ( ) - -
Email Address:		Re-enter Email Address:

Check here if we may contact you to get your feedback or to inform you of new products. Please check all communication options that you would prefer. Email Phone Fax Mail


Model Number:	Serial Number:	Date of Purchase: (ex: March/25/2000) / /
Olympus Dealer or Sales Representative product was purchased from:

1. How many microscopes do you have in your lab?
Please check one: (0 = first time buyers)
0 1-5 6-10 11-19 20+

2. Who is the primary manufacturer of your microscopes?
Olympus Other Other

3. What is your current satisfaction level with your primary manufacturer? (Rating scale of 1-10 with 10 being the highest.)

4. When you purchased your Olympus system, what was your satisfaction level with the Olympus Dealer/Sales Rep? (Rating scale of 1-10 with 10 being highest.)

Comments:

5. How satisfied were you with the installation support? (Rating scale of 1-10 with 10 being highest.)

Comments:

6. It is important for us to provide products of the highest quality both in terms of performance and reliability. How would you rate the quality of Olympus microscopes? (Rate from 1-10 with 10 being very satisfied.)

Comments:

7. Which of the following trade publications to you read regularly? (Please check all that apply):

	ASC Bulletin		Journal of Cell Biology
	Advance for Administrators		Journal of Neuroscience
	American Biotech Lab		Lab Equipment
	American Lab		Microscopy & Analysis
	Biomedical Products		Modern Drug Discovery
	Biophotonics Intl		Nature
	Biophysical Journal		R&D
	Biotechniques		Science
	CAP Today		The Scientist
	Clinical Lab Products		Other (Please Specify)
	Drug Discovery

8. How often do you log onto the Internet?
Daily	Weekly	Monthly	Rarely/Never

9. What is your main reason for using the Internet?
Research	New Product Information	Personal	Other

10. What is your primary application? Please check one:
Clinical	Industrial	Research	Other


11. If you have ever requested service or maintenance of your existing Olympus microscope(s), please rate your overall satisfaction of the way your request was handled by Olympus and/or the authorized Olympus Service Center? (Rate from 1-10 with 10 being very satisfied)
Comments:

Your privacy is a priority to us.
At Olympus, it is our obligation to you as a valuable customer to protect the trust you have placed in us, including safeguarding any information you share on this questionnaire. Occasionally, we work with other reputable companies that manufacture products that we think might be interesting to you. Many of our customers find these offers helpful. However, if you would prefer not to receive promotional offers from other companies, please let us know by simply checking the box.