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Custom Project Request Form
Qioptiq Imaging Solutions offers a full spectrum of optical outsourcing services to provide our customers with open access to cost-effective imaging solutions and immediate project assistance. Please fill out and submit the form below and our custom department will contact you within 24 to 48 hours.
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Company:
Contact:
Street:
City:
State:
Zip:
Country:
E-Mail:
Phone:
Ext.
Fax:
Field of View: (Vertical x Horizontal)
x
(mm)
Minimum Working Distance (mm):
Type of Optical System:
Zoom
Fixed
Multiple Fixed Power
Camera Format:
1/4"
1/3"
1/2"
2/3"
1"
Other
Camera Mount:
CS
C
F
4/3
Other
Wavelength Spectrum:
Select One
UV
Visible Light
NIR
Nanometers
Image Orientation on Monitor:
Select One
Erect
Non-Erect
Select One
Reversed
Unreversed
Illumination Requirements
Through the Lenses (Coaxial)
Outside Optical System (Ring Light)
Other
Specify Other:
Smallest Dimension to be Imaged
Select One
Microns
Mils
Describe Specimen(s) to be Viewed:
Maximum Length Restrictions (Specimen to Camera):
mm
Physical Restrictions:
Width:
Height:
Weight:
Other:
Focusing Requirements
Select One
Internal
External
Both
Budgetary Limits:
Prototype ($):
Production ($):
Quantity:
Initial:
Annual:
Other Components Needed (X-Y, Motors, Mounting)
Applications/Special Needs/Sketches (Please Attach):
Delivery Timeframe
Months