Appendix A: Customer Checklist - GE Discovery NM/CT 670 Instructions Manual

Appendix A: Customer Checklist

The checklist must be completed by the customer and delivered to GE prior to installation.
IMPORTANT
This checklist is general in nature and is intended to assist the customer in verifying site preparation. The checklist
does not cover all details in this manual, and it is the customer's responsibility to fully prepare the site, taking into
account all details and specifications set out in this manual.
Site Information Contact Information
Site name
Department
Street
City, State, Zip
Country
Telephone
Fax
I hereby confirm that the relevant site personnel have read the
System Overview Manual
, in conjunction with this Site Preparation Manual.
I hereby confirm that pre-installation is complete and that I have examined and
confirmed all items in the Pre-Installation Customer Checklist
Discovery NM/CT 670 – Standard Integration Instructions
5483063-1EN, Rev.2, ©2015 GE Healthcare
Contact Persons
Site project coordinator
System administrator
Chief technologist
Facilities engineer
Shipping/Receiving
Physician
Other
Safety Declaration
Safety and
Completion Sign Off
A-1
Name Telephone
Name
Position
Signature
Name
Position
Signature
-
email