CHECKLIST CLINIC #

GENTLE MAX PRO MACHINE

NAME:

MONTH:
MACHINE 1 2 3 4 5 6 7 8 9 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 2 3
0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 4 5 6 7 8 9 0
CLEAN HAND PIECE OUTSIDE
LENS
CLEAN HANPIECE INSIDE LENS
CHECK WATER LEVEL (NECK)
CHANGE INSIDE LENS
CHANGE OUTSIDE LENS

SIGNATURE