Follow the steps to complete the online form accurately.

1. Click ‘Get Form’ button to access the form and open it in your preferred online document editor.
2. Begin by entering the site information, including the UAP/BUAP number, system manufacturer, and system serial number. Ensure accuracy in these fields, as they are essential for identification.
3. Fill out the details of the medical physicist or their designee, including their name and signature. This confirms that the evaluation has been conducted appropriately.
4. Record the report date and the survey date. These dates are important for maintaining the timeline of the evaluation process.
5. Provide the model and transducer numbers. This information is necessary for asset tracking and accountability.
6. For the system sensitivity section, indicate the maximum depth of visualization achieved under the specified conditions by marking the appropriate box. Choose from the provided depth options ranging from less than 3 cm to 15 cm.
7. In the uniformity section, assess the image by freezing it and answering the questions with a rating of 1, 2, or 3 based on visual observation. Mark the boxes that correspond to your evaluation.
8. Complete the scanner electronic image display performance section by selecting whether the display has been completed, not completed, or is not applicable.
9. Evaluate the electrical and mechanical safety, as well as cleanliness, by answering yes or no to the provided questions. If corrective action is required, provide details in the designated space.
10. Use the additional comments section to add any relevant information that may assist the evaluation process.
11. Once all sections of the form are completed and reviewed for accuracy, save the changes. You may then download, print, or share the form as required.

Complete your documents online today to ensure thorough and accurate evaluations.