Imaging Molecules to Man. Fault Report

MRI RF COILS

This form must be completed and shipped with all products returned to m2m Imaging for repair. Taking time to fill out this form will help us to troubleshoot your RF Coil and have it returned to you sooner.

MRI RF Coil Information
Description R2 10-40/MI - 300
Part and Serial Number 50-11-1118/100 REV:00

Fault	Yes	No
Can it match
Does it have enough tuning range
Is this the first time you used the coil
Has the coil operated correctly previously

Imaging Information	Description
Sample
Frequency

If possible please send an image taken with the coil showing the problem.

Other Information

Please note. The signatory and/or sender guarantees that the returned product is free of any contamination, hazardous samples and/or other dangerous substances (e.g. toxins, corrosive agents, explosives, biologically dangerous or radio active samples/substances).

Any violation of this declaration shall result in the signatory/senders liability for any damage caused to M2M IMAGING CORP. and/or its employees.

I have read and agreed to these terms & conditions.

Company/Institute
Name
City, Postal/zip Code, Country

For enquiries regarding any of our products or for more information about us please contact us on:

T: +1 877 887 8989 (toll free) or +1 440 684 9690
F: +1 440 684 9695
E: [click here]

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