We buy C-Arm Systems throughout the USA

Your Name: *

System Owner: *

Phone Number: *

Your email address: *

Equipment Location: *

Model Number: *

Serial Number:

Date of Manufacture:  *

 Operating Condition:

Click to Select Working Condition Not Working

Image Intensifier Size:

Features:
Check those that apply) 

FootswitchHandswitch Manuals

Edge Enhancement  Gamma Correction DSA Digital Subtraction  Road Mapping
Pulsed FluoroHi-Level Pulsed Fluoro  Printer  Integrated DICOM 
DICOM Box Add-On  USB PortVCR  Laser Aimer  Cine Mode

 Overall Appearance

Needs Paint  Has Dents & Scratches

Known Issues:

High Voltage Cables:

Click to Select Good Condition Some Cracks or Damage

Last Battery Replacement Date:

Collimation: *

Click to Select Very Good Acceptable Needs Adjustment

Dose Control:

Click to Select Acceptable Needs Calibration

 X-Ray Tube: *

Click to Select Good Noisy Some Arching

Image Quality: *

Click to select Unknown Excellent Good Fair Poor

Last PM Check:

Last Date under Service Agreement:

Security Code: *