Installation Check List
Customer Information
Company
Address
Contact
Phone
Email
Reference
Sales Order #
WO #
Zoho #
Date
Technician Name
Select Equipment to Install
Chair
Instrument Stand
Slit Lamp
Digital Slit Lamp
Applanation Tonometer
Hand Held Scopes
Indirect
Acuity Chart / Projector
Trial Frame / Lens Set
Chair
+ Add Another Chair
Room:
Manufacturer
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Model
S/N
Condition
New
Good
Fair
Poor
Motor (recline/down etc)
Mechanical (analog functions)
Electrical (wires, connections, power)
Upholstery
Equipment is clean and wiped
Cleaned area with vacuum after install
Boxes and packing material has been removed
Installed and functional
Yes
No
Instrument Stand
+ Add Another Stand
Room:
Manufacturer
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Model
S/N
Condition
New
Good
Fair
Poor
Stand Installation & Maintenance
Mechanical (analog functions)
Electrical (wires, connections, power)
Overhead Lamp (wires, connections, power)
Leveled phoropter arm
Leveled SL arm
Wiped dust off
Checked lubrication to all moving mechanism
Cleaned area with vacuum after install
Boxes and packing material has been removed
Installed and functional
Yes
No
Slit Lamp
+ Add Another Slit Lamp
Room:
Manufacturer
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Model
S/N
Condition
New
Good
Fair
Poor
Installation & Final Steps
Optics (clean)
Secured and concealed cabling
Leveled SL
Cover SL after install
Boxes and packing removal
Clean Area with vacuum after install
Installed and functional
Yes
No
Digital Slit Lamp
+ Add Another Digital SL
Room:
Manufacturer
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Model
S/N
Condition
New
Good
Fair
Poor
Digital Setup & Installation
PC / Network Connection
Software / Driver Install
Secured and concealed cabling
Leveled DSL
Cover SL after install
Boxes and packing removal
Clean Area with vacuum after install
Installed and functional
Yes
No
Applanation Tonometer
+ Add Another Applanation Tonometer
Room:
Manufacturer
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Model
S/N
Condition
New
Good
Fair
Poor
Verification & Cleanup
Calibration Pass
Mechanical functions
Alignment with optics
Wipe down Tonometer
Boxes & packing removal
Vacuum area
Installed and functional
Yes
No
Hand Held Scopes
+ Add Another Hand Held Scopes
Room:
Manufacturers
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Models
S/N
Condition
New
Good
Fair
Poor
Functionality & Customer Instruction
Cleaned / Sterile
Mechanical functions (analog)
Light Functionality
Charges Properly
User Instructed:
Charge for at least 24hr
Boxes & packing removal
Installed and functional
Yes
No
Indirect
+ Add Another Indirect
Room:
Manufacturer
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Model
S/N
Condition
New
Good
Fair
Poor
Installation & Functional Check
Optics (clean)
Mechanical (analog functions)
Electrical (wires, connections, power)
Light Intensity
Charging (Optional)
Mounting & Site Actions
Spoke with customer for placement
Used proper Anchors for wall type
Cable management
Boxes & packing removal
Clean area with vacuum after install
Installed and functional
Yes
No
Acuity Chart / Projector
+ Add Another Acuity Chart / Projector
Room:
Manufacturer
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Model
S/N
Condition
New
Good
Fair
Poor
Calibration & Mounting
Calibration (correct distance)
Check Power / Remote Sync
Mirror (optional/aligned)
Patient view check (clear line of sight)
Used proper Anchors for wall type
Final Site Actions
Cable management
Boxes & packing removal
Clean area with vacuum after install
Installed and functional
Yes
No
Trial Frame
+ Add Another Trial Frame
Room:
Manufacturer
Model
S/N
Condition
New
Good
Fair
Poor
Functional Check
Mechanical (analog functions)
Lens Alignment
Spoke with customer for storage/placement
Site Actions
Wipe down equipment
Boxes & packing removal
Clean area with vacuum after install
Installed and functional
Yes
No
Trial Lens Set
+ Add Another Trial Lens Set
Room:
Manufacturer
Model
S/N
Condition
New
Good
Fair
Poor
Inventory & Placement
Set Is Complete
Spoke with customer for storage/placement
Site Actions
Wipe down case/lenses
Boxes & packing removal
Clean area with vacuum after install
Installed and functional
Yes
No
Customer Sign-off
Clear Signature
Complete Installation