Appendix
17 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
Order number (REF) Serial number (SN)
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: Signature:
Name and address of the qualified adviser for the medical device:
Date of handover: Signature of the qualified adviser for the medi-
cal device:
Appendix
5152100003L02 1910V001 41
EN
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