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Application Questionnaire

Please complete this questionnaire about your application. We'll use the information as a basis for providing you an estimate.


Please note: Drawings and photos are very helpful! These can be submitted via email to sales@viperimaging.com. Thank you!


Please enter phone number without dashes (i.e. 1234567899).

If yes, please select name from list.

i.e. rough, polished, oxidized, etc.

Include ambient temperature, classification (i.e. Class I Div II), conditions at measuring point, and other factors such as dust, smoke, steam, etc.

Overall size (L x H x W) and spot size (smallest target)

If yes, please describe.

If yes, how fast and in what direction?

(i.e. monitoring only, safety, process control, etc.)

If yes, please describe.

If yes, in what format? (i.e. thermal data, visual, both)

If other, please specify.

What best describes the timeline for this project?