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Laser Camera Valuation or Trade-in Form

 

Please use this form if you are selling your used equipment and would like CIS to contact your with an offer. If you are an OEM looking for a trade-in value please submit the completed form and someone from CIS will contact you shortly.

Facility / OEM / Owner:
 *
Address:
Contact:
 *
Phone:
Email address:
 *
 
Manufacturer:
Date of manufacture:
Model:
List the number of inputs and note analog or digital:
System memory:
Number of keypads:
Number of keypad interface boards. (KIEBS)
Number of video interface boards. (VIEBS)
Number of digital interface boards. (DIEBS)
Is there a send magazine?
Is there a receive magazine?
Is there a docking unit coming with the system?
Processor model, if so equiped:
List the make and model of the system(s) the laser is interfaced with:
Does the system have any operating problem? If so please describe:
Operationial condition:
Cosmetic condition:
Who services the system?
When is the system available for removal?
Do not enter anything in this field:
* indicates a required field

Currently Looking to Purchase:
  • GE CT Scanners
  • Multi-Slice CT
  • CR Units
  • Open MRIs
  • HF Rad Rooms

 

    Now Available:
    • GE Light Speed 16
    • GE QX/i 4
    • GE NX/i Dual
    • Philips Brilliance 64
    • GE 1.5 Shortbore Mobile
    • Siemens Symphony

     


      Clinical Imaging Systems, Inc.
      522 Highway 9 North Suite 321
      Manalapan, NJ 07726  
      Toll Free: 1-866-585-7164
      Phone: 1-732-591-9510  
      Fax: 1-732-226-3168
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