Get Sterilization Monitoring Service Registration Form - Unc School Of ... - Dentistry Unc

Completing the Sterilization Monitoring Service Registration Form is essential for dental practices seeking to register their sterilization equipment and monitoring services. This guide provides clear, step-by-step instructions to assist you in filling out the form accurately and efficiently.

Follow the steps to complete the registration form seamlessly.

1. Click the ‘Get Form’ button to access the Sterilization Monitoring Service Registration Form. Ensure you open the form in a suitable document editor.
2. In the first section, provide the name of your dental practice. This will identify your organization on the registration form.
3. Next, complete the mailing address section. Input the street address, city, state, and zip code accurately to ensure effective communication.
4. Fill in the contact person’s name. This person will be the primary contact for any inquiries regarding the registration. Ensure you also include their telephone number and email address.
5. Indicate the fax number, if applicable. This will be used for further communications related to sterilization monitoring services.
6. Move to the sterilizer information section. Check the appropriate box to specify if you are registering a new service or changing existing sterilizers.
7. If registering a new sterilizer, provide the manufacturer, model number, and serial or ID number of the sterilizer.
8. If you are changing existing sterilizers, complete the section for adding a new sterilizer by following the same instructions as step 7.
9. If you are replacing an existing sterilizer, provide the barcode number along with the manufacturer, model number, and serial or ID number for both the existing and the replacement sterilizer.
10. Finally, ensure to sign the form with the dentist’s signature and date it appropriately. This signature certifies the information provided in the form.
11. Once completed, review the form for accuracy. You may then save your changes, download a copy for your records, print the form, or share it via email or fax to the provided contacts.

Complete your registration for sterilization monitoring services online now!