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Installation Check List
Customer Information
Company
Address
ONSITE
Contact
Phone
Email
Reference
Sales Order #
WO #
Zoho #
Date & Time
Technician Name
Select Equipment to Install
Examination Chair
Instrument Stand
Slit Lamp
Digital Slit Lamp
Applanation Tonometer
Hand Held Scopes
Indirect Ophthalmoscope
Acuity Chart / Projector
Trial Frame / Lens Set
Examination Chair
+ Add Another Chair
Room:
Manufacturer
Select Manufacturer...
Model
S/N
Condition
New
Good
Fair
Poor
Inspection
Motor (recline/down etc)
Mechanical (analog functions)
Electrical (wires, connections, power)
Upholstery
Final Site Actions
Equipment is clean and wiped
Cleaned area with vacuum after install
Boxes and packing material has been removed
Installed and functional
Yes
No
Instrument Stand
+ Add Another Stand
Room:
Manufacturer
Select Manufacturer...
Model
S/N
Condition
New
Good
Fair
Poor
Inspection
Mechanical (analog functions)
Electrical (wires, connections, power)
Overhead Lamp (wires, connections, power)
Leveled phoropter arm
Leveled SL arm
Checked lubrication to all moving mechanism
Final Site Actions
Wiped dust off
Cleaned area with vacuum after install
Boxes and packing material has been removed
Installed and functional
Yes
No
Slit Lamp
+ Add Another Slit Lamp
Room:
Manufacturer
Select Manufacturer...
Model
S/N
Condition
New
Good
Fair
Poor
Inspection
Optics (clean)
Mechanical (analog functions)
Electrical (wires, connections, power)
Light Intesity (bulb quality)
Secured and concealed cabling
Leveled SL table
Covered SL after installion
Final Site Actions
Boxes and packing material has been removed
Consulted with customer regarding accessories placement.
Clean Area with vacuum after install
Installed and functional
Yes
No
Digital Slit Lamp
+ Add Another Digital SL
Room:
Manufacturer
Select Manufacturer...
Model
S/N
Condition
New
Good
Fair
Poor
Inspection
Optics (clean)
Mechanical (analog functions)
Electrical (wires, connections, power)
Light Intesity (bulb quality)
Secured and concealed cabling
Leveled SL table
Covered SL after installion
Final Site Actions
Boxes and packing material has been removed
Consulted with customer regarding accessories placement.
Clean Area with vacuum after install
Installed and functional
Yes
No
Applanation Tonometer
+ Add Another Applanation Tonometer
Room:
Manufacturer
Select Manufacturer...
Model
S/N
Condition
New
Good
Fair
Poor
Inspection
Calibration Pass
Mechanical functions
Verified the alignment with optics
Final Site Actions
Cleanned the exterior of the tonometer
Boxes and packing material has been removed
Consulted with customer regarding boxes and accessories placement.
Clean Area with vacuum after install
Installed and functional
Yes
No
Hand Held Scopes
+ Add Another Hand Held Scopes
Room:
Manufacturers
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Models
S/N
Condition
New
Good
Fair
Poor
Inspection
Verified optics are clean
Mechanical functions (analog)
Light Functionality
Charges Properly
User Instructed:
Charge for at least 24hr
Final Site Actions
Boxes and packing material has been removed
Consulted with customer regarding boxes and accessories placement.
Clean Area with vacuum after install
Installed and functional
Yes
No
Indirect
+ Add Another Indirect
Room:
Manufacturer
Select Manufacturer...
Model
S/N
Condition
New
Good
Fair
Poor
Inspection
Consulted with customer regarding placement for installation.
Used proper Anchors for the wall type
Verified Cable management
Optics (clean)
Mechanical (analog functions)
Electrical (wires, connections, power)
Light Intensity
Charging (Optional)
Final Site Actions
Boxes and packing material has been removed
Consulted with customer regarding boxes and accessories placement.
Clean Area with vacuum after install
Installed and functional
Yes
No
Acuity Chart / Projector
+ Add Another Acuity Chart / Projector
Room:
Manufacturer
Select Manufacturer...
Model
S/N
Condition
New
Good
Fair
Poor
Inspection
Calibration (correct distance)
Check Power / Remote Sync
Mirror (optional/aligned)
Patient view check (clear line of sight)
Used proper Anchors for wall type
Final Site Actions
Cable management
Boxes & packing removal
Clean area with vacuum after install
Installed and functional
Yes
No
Trial Frame
+ Add Another Trial Frame
Room:
Manufacturer
Model
S/N
Condition
New
Good
Fair
Poor
Inspection
Mechanical (analog functions)
Lens Alignment
Spoke with customer for storage/placement
Site Actions
Wipe down equipment
Boxes & packing removal
Clean area with vacuum after install
Installed and functional
Yes
No
Trial Lens Set
+ Add Another Trial Lens Set
Room:
Manufacturer
Model
S/N
Condition
New
Good
Fair
Poor
Inspection
Set Is Complete
Spoke with customer for storage/placement
Site Actions
Wipe down case/lenses
Boxes & packing removal
Clean area with vacuum after install
Installed and functional
Yes
No
Customer Sign-off
Clear Signature
Complete Installation