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Document No.: 985-007011
Revision: A
Effective Date: 08/07/2012
Odyssey
Quad HD System Installation
Verification and Testing
Page 19 of 19
“WARNING: This is a revision controlled document. Verify revision is correct prior to use.”
Stereotaxis, Inc
Confidential
5. Odyssey Quad HD System Verification Checklist
Section
Description
Pass/Fail
Initials
3.3
Odyssey Quad HD System Verification Testing
P F
I hereby certify that the Odyssey Quad HD System is installed and functioning within published
specifications:
Signature:
_______________________________ Date: ________________
Print Name:
_______________________________
Company Name: ______________________________
6. Installation Complete Checklist
Section
Description
Pass/Fail
Initials
2.
Site Information and Document Instructions
P F
3.1
Electrical Power System
P F
3.2
Electrical Safety Verification
P F
3.3
Odyssey Quad HD System Verification
P F
4.
Peripheral Functionality
P F
N/A
Item
Yes / No
Initials
Installation Completed in Accordance with HDW-0188 Odyssey
Workstation Installation Manual
Y N
Signature:
Date:
Print Name: _________________________________
Company Name: _____________________________
Return a copy of the completed sections of this document along with all attachments to Manager of
Field/Tech Support
Stereotaxis Management Sign off
Sign Name:
______________________________
Date: _____________________
Print Name:
______________________________