Prosonic NeoMatic IIe, Инструкция по эксплуатации

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IMPORTANT NOTICE FOR
PROSPECTIVE HEARING AID USERS (cont’d):
Statement of Waiving Medical Evaluation - Federal law
allows for a fully informed individual to sign a written waiver
of the medical evaluation provided all of the conditions
stated in the preceding page are met:
I have been advised by the distributor that the Food and Drug
Administration has determined that my best health interest
would be served if I had a medical evaluation by a licensed
physician (preferably a physician who specializes in diseases
of the ear) before purchasing a hearing aid.
I do not wish a medical evaluation before purchasing a
hearing aid.
Waiver signature ______________________
Date signed __________________________
The prospective user is required to mail a signed copy of the
Statement of Waiving Medical Evaluation to
the Customer
Service Center of the ProSonic Hearing Sound Amplifier at
P O Box 1000, Bellingham WA 98225, U.S.A.
Each Statement
of Waiving Medical Evaluation will be on record kept for three
years on submission.