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Appendix
16 Handover record
This document confirms that a qualified handover of the medical device has taken place and that
appropriate instructions have been provided for it. This must be carried out by a qualified adviser for the
medical device, who will instruct you in the proper handling and operation of the medical device.
Product name
o Visual inspection of the packaging for any damage
o Unpacking the medical device and checking for damage
o Confirmation of the completeness of the delivery
o Instruction in the proper handling and operation of the medical device based on the operating
instructions
Notes:
Name of person receiving instruction:
Name and address of the qualified adviser for the medical device:
Date of handover:
50
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EN-US
Order number (REF)
Signature:
Signature of the qualified adviser for the
medical device:
Serial number (SN)
2144100140L29
G8802
2310V007
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