112 | UM-PP-EN-03
Confirmation of Installation and Training Record
With the signing of the instruction record, the instructor and the customer confirm the carrying out
of qualified instruction and installation. Disregarding of warnings, safety requirements, intended
and the prohibited use, as well as unauthorized or improper maintenance and/or repair and/or
technical safety inspection can cause injury or even death, and/or may damage the device and/or
lead to loss of all material defect liability claims and any other liability claims. Please fill out the
instruction protocol completely and return it to WOODWAY.
WOODWAY Slat Belt Treadmill
Serial No.:
____________________________
Model:
____________________________
The above treadmill was properly set up / installed on:
__________________________
(Date)
Technical instruction was completed on:
__________________________
(Date)
Place of transfer / instruction: __________________________________________________________
__________________________________________________________
__________________________________________________________
The following persons received instructions:
_______________________________________
_______________________________________
(Name and role)
(Signature)
_______________________________________
_______________________________________
(Name and role)
(Signature)
_______________________________________
_______________________________________
(Name and role)
(Signature)
_______________________________________
_______________________________________
(Name and role)
(Signature)
Remarks:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________
_______________________________________
(Location, Date)
Name (printed capital letters) and signature of
Instructor (Medical device consultant)
