Loaner Unit
A loaner equipment was provided to the customer since their main unit is out of service. The equipment was previously inspected and tested, confirming proper operation. Its brand, model, serial number, and physical condition at the time of delivery were documented. The customer was informed about the proper use of the equipment and accepts responsibility for its care, agreeing to return it in the same condition once their original unit is operational.
Loaner Unit
A loaner equipment was provided to the customer since their main unit is out of service. The equipment was previously inspected and tested, confirming proper operation. Its brand, model, serial number, and physical condition at the time of delivery were documented. The customer was informed about the proper use of the equipment and accepts responsibility for its care, agreeing to return it in the same condition once their original unit is operational.
Reason for loan documented
Loaner Equipment Information
Brand and Model
Serial Number
Accesories Include
Describe parts of the unit, Power cord, cables, controls etc.
Physical condition at time of delivery:
Functional verification:
Picture condition at time of delivery
Add or drag pictures
Name of the authorize personnel receiving the equipment
Signature of authorized representative
Customer informed of responsibility for care, loss, or damage. Customer agrees to return the equipment in the same condition
Click here to sign
Source: Serenity Medical LLC (Community Member)
