Masterflex Applications Assistance Form

Applications Assistance

For assistance with your application please fill out this form as complete as possible so that our Applications Specialists can help you.

Items with

are required

Company:

Address:

Title:

City:

Contact Person:

State:

Zip:

Call Back Requested:

yes no

Best time to call:

Phone Number:

Fax Number:

Email:

Tubing Information
Flow Rate:
Viscosity:
Temperature:
Abrasive/Particulates in fluid:
Inlet Pressue:
Is clarity of tubing important:
Fluid to be pumped:
Discharge pressure/ head:
Agency approvals required(UL,cUL,CE,etc):
Pump Head
Will you be using more than one size of tubing?:
How many channels do you need?:
Is convenience or price a bigger concern?:
How often will you change tubing?:
Is adjustable occlusion required (for higher pressure or pumping large particles?):
Drive
Fixed or variable speed:
Dispensing accuracy:
Power requirements:
Environmental approvals:
Electrical approvals:
Digital display:
Flowrate accuracy:
Remote control:
Programmable:
Computer interface:

Comments:

Please add any comments that will help describe your application: