Annex 1
Customer:
Address:
Reason:
□ Other
Bed type:
Model:
Installation:
Manufactu-
rer:
Class:
I. Visual check
Visual check: electronic components
Markings/labels
Controller housing
Motor housing
Battery
Motor brackets
Manual switch
Motor and manual switch
cables
Controller connections
Strain relief for power ca-
ble
Visual check: mechanical components
Markings/labels
Up/down system
Transport castors
Welds/seams
Maintenance and servicing checklist
□ Check on delivery
□ Care bed
□ Not a care
EOS Relax
Class I non-invasive medical equipment
present
Position correct,
damage
Position correct,
damage
Age
Bolts and fuses
Cracks, damage
Check cable and
attachment
Properly con-
nected, O-rings
present, bayonet
fitting
Firmly fitted
present
Damage, deforma-
tion
Damage
Cracks, deforma-
tion
□ Periodic check
□ Check after repair or maintenance
□ Protection
bed
class: I
ID no.:
OK
99
□ Protection class: II
NOK
Fault description