57
PowerLyzer 24 Homogenizer User Manual 09/2018
Decontamination procedure used (required for equipment/instruments before return):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Other comments (attach additional comments if needed):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Include this form with the returned item.
Signature:______________________________________ Date sent:________________________
Print name:____________________________________
I hereby state that the above information is true and the item I am returning has not been
tampered with and/or contaminated. If during QIAGEN decontamination testing it is found
that the product has been tampered with and/or contaminated, I understand that I will not
receive a refund or a credit to my account.
