Equipment Maintenance Form


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ALEX & YAG


ALEX - Maintenance *
 YesNo
Tech Goggles Checked & are in Good Condition
Patient Goggles Checked & are in Good Condition
Slider Lens Checked for Pitting (hold up into light)
Slider Window Checked (replace if needed)
Laser Fiber Checked
Calport Clean
Water Level Checked
Distance Gauges Cleaned & PHOTO taken
Calibration Done (18mm 20J) & PHOTO taken
Filter (Lt side bottom) PHOTO taken & Cleaned
YAG - Maintenance *
 YesNo
Tech Goggles Checked & are in Good Condition
Patient Goggles Checked & are in Good Condition
Slider Lens Checked for Pitting (hold up into light)
Slider Window Checked (replace if needed)
Laser Fiber Checked
Calport Clean
Water Level Checked
Distance Gauges Cleaned & PHOTO taken
Calibration Done (15mm 44J) & PHOTO taken
Filter (Lt side bottom) PHOTO taken & Cleaned


LVM SCREEN DETAILS
ALEX = HV>1800 BAD, HD>68 BAD, CP must be less than HD, TX<70BAD
YAG  = HV >1100 BAD, HD>98 BAD, CP must be less than HD, TX<70BAD * 
 Total PulsesHVHDCPTX
ALEX
YAG

ALEX PHOTOS




YAG PHOTOS






Mesopen & Ultrasonic

Ultrasonic - Electrical Cord Straightened *




Supply Room





CRYO Canisters

ALEX & YAG WINDOWS

 Total NEW Left in Inventory
ALEX Windows
YAG Windows




Zeltiq Cards (If Relevant)