Devices that receive XRV Tags: CR, DR, Xray Control, Dental, Processor, Ultrasound, Biomed, Digitizers, Printers, DEXA. Devices that DO NOT receive XRV Tags: X-ray Tubes, Collimators, Tubestands, Tables, Power Modules.

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Required field*

XRVTag*

Your Email*

Reason for New Sticker*

Contact*

Facility/Clinic*

Shipment # *

Address*

Contact Email*

Contact Phone*

Equipment Type:*

Equipment Manufacturer*

Model*

Serial*

Reference # (K #)*

Location (ie. Room 1)*

Manufacture Date*

Install Date*

Notes (Info on Secondary Components):