Clinical Imaging Systems - Laser Camera Spec Sheet

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