Declaration by the prescriber:
I confirm that I have shown all of the above to (name of carer) and I am
confident that they have understood. I have given them details of how to contact me in the case of need.
Signature ...................................................................................................
Name (block capitals) ................................................................................
Contact Details ..........................................................................................
Product Handover
Declaration by the carer:
I confirm that I have been shown how to use the name of product)
I confirm that I know how to adjust the areas that I need to adjust and I know what adjustments
I must not make. I understand that failure to follow these instructions may pose a danger to the
child using the product. I understand that I am responsible for inspecting the product in the
manner in which I have been trained today and I know how to contact:
(name of prescriber) should I have any questions.
Signature ...................................................................................................
Name (block capitals) ................................................................................
Содержание Junior
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