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RISMED Services - Linear Accelerator Evaluation Form
Please complete this evaluation form on the Linear Accelerator becoming available at your facility. We will respond to your inquiry as quickly as possible.

Contact Information
Name:
 Company:
Title:
 Address:
Address 2:
 City:
State/Province:
 Zip/Postal:
Country:
 Telephone:
Fax:
 Email:


Linear Accelerator Information
Brand
 Model
Year
 Serial #
Software Version

Photon Energy: Single Dual
Low Energy Photon
MV 		High Energy Photon
MV 		Electrons:
MeV
Beamstopper Counterweight
Power Supply: Digital   Analog
Removable Energy Switch: Yes No


Please Enter Age Of Components
Magnetron
/ / 		Thyratron
/ / 		Klystron
/ /
Waveguide
/ / 		Electron Gun
/ / 		RF Driver
/ /

Couch Type
 Dynamic Wedges
Yes No 		Wedge Sizes
Elec. Applicator Sizes
 Beam Hours
 Filament Hours

Independent Jaws:
Single Dual 		Accessory Type:
I II III

List any other major components that may have been replaced
Has this unit ever been refurbished? If yes, when and by whom?

Does the system include:
Yes No     Lasers
Yes No Manuals
Yes No Spare Parts Kit
Yes No Base Frame


Unit Availability
Is unit still in service: Yes No
If yes, date unit be available for deinstallation? / /
If no, how long has unit been out of service:
Vacuum still on waveguide: Yes No
Last date serviced: / /
If this unit is being replaced by a new system, when is the installation scheduled to begin: / /


Terms of Sale
Accepting offers until / /
Asking price $
Contact Person
Comments:

 
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