Get Field Safety Notice Response Form For Users

Completing the Field Safety Notice Response Form for Users is an essential step for ensuring the safety and compliance of the recalled devices. This guide will provide you with clear, structured instructions to assist you in filling out the form accurately and efficiently online.

Follow the steps to complete the form seamlessly.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Enter the date in the designated field at the top of the form. This is the date on which you are completing the form.
3. Provide your name in the corresponding field. Ensure that you use your full legal name as it appears in your official documents.
4. Fill in your job title. This should reflect your current position in your hospital or institution.
5. Input the name of your hospital or institution in the designated area. Make sure the spelling is correct for proper identification.
6. Complete the address section with the full address of your hospital or institution.
7. Refer to the section that lists the recalled devices. Enter the lot number, quantity shipped, quantity found on inventory, quantity used, and quantity to be returned in the appropriate fields.
8. Indicate whether you have received any reports of malfunctions with these devices by selecting ‘NO’ or ‘YES’.
9. Acknowledge receipt of the Field Safety Notice by providing your name, date, and signature in the specified fields.
10. Provide the contact information of the institution representative for follow-up regarding the return and replacement of the affected devices.
11. Finally, save your changes, and use the options available to download, print, or share the form as needed.

Fill out your Field Safety Notice Response Form online today to ensure your compliance and safety.