Ductless Fume Hood Application Questionnaire

Mystaire® Misonix® would like to thank you for your interest in our product line. In order to provide you with an accurate price quotation, please complete the information below and a technical sales representative will process your request. Thank you for your interest and trust in Mystaire® Misonix® safety products.

1. Describe the application to be completed within the hood.

2. What chemicals will be manipulated inside the hood?

Chemical Name: Concentration: Volume
Evaporated
per day:		 Frequency used in hood:

3. During your application, will any of the chemical(s) be heated inside the hood?

4. Describe the laboratory environment that the hood will be placed in.

5. Do you want the hood to protect:

6. What size hood best fits your application and work area?

7. Equipment inside the hood can affect containment.
Will any equipment be used inside the hood?


8. How many linear feet of hood space is required for your application?*

9. Are you interested in:
10. How did you hear about Mystaire® Misonix®?   
Please complete all the information below so our technical sales staff can provide you with accurate product information and pricing.
Your Name:*
Company Name:
Address:*
Address (Cont):
City:*
State/Province:*
Postal Code:*
Country:*
Phone*/Ext:
Fax:
Email Address:*

By submitting this application, I warrant that the information provided is complete and accurate.
Fields marked with an (*) are required. Click Submit button only once.