Clinical Imaging Systems

Special Procedures Room 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:
*
Type of room:

Date of manufacture:

Model:
Generator(s) model(s):
Single or bi-plane:

Table model:
Is the table stepping top?

C-arm model:
Age of the x-ray tube:
Age of the image intensifier:
Size(s) of the image intensifier:
TV chain model:
Number and size of the monitors:
Does the system have digital? If so what is the model:
Does the system have a cine camera? If so what is the model:
What type of film changer is with the system?
List any accessories coming with the system:
Does the system have any operating problems? If so please describe:
Operational 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