Register-Unit-1132

Registration Date*

The date you received and began using your Equinosis Q System.

Practice Name*

The name of the company, institution or business entity acquiring the Equinosis Q System.

Practice Description

This description will be placed on the equinosis.com FIND A VET map. Feel free to use your primary language as this will help improve where your practice shows in a search in your country.

Phone

Practice Website

Practice Facebook

Needed to link to on the equinosis.com FIND A VET map.

Name (Primary Contact)*

Who to contact for contract or purchase decisions, including software license support membership status.

Prefix First Middle Last Suffix

Email (Primary Contact)*

Name (Primary User)*

The veterinarian who will be using the system the most and/or is committed to completing new user training.

Prefix First Middle Last Suffix

Email (Primary User)

Additional Users/Emails

Contact information for other users of the Equinosis Q System. Include any Vet Techs/Assistants/Nurses that will be using or assisting with the system or purchasing supplies that are not already listed above. Note that SEPARATE email addresses are needed for each individual that would like to complete training.

This field is hidden when viewing the form

IP Address

This field is hidden when viewing the form

Untitled

This field is hidden when viewing the form

Untitled

This field is hidden when viewing the form

Untitled

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping Address (leave blank if same as "Billing")

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Equinosis Q System Serial Numbers to Register

According to our records, you are registering the following devices. Please confirm that the numbers match what you have received and correct any errors.

Number of Tablets to Register

Please enter a number from 0 to 60.

Number of Sensors to Register

Please enter a number from 0 to 60.

Number of Bluetooth Adapter Dongles to Register

Please enter a number from 0 to 60.

Number of Sensor Charging Stations to Register

Please enter a number from 0 to 60.

Tablet Serial Numbers

Tablet 1

Computer Name for your Tablet PC

Tablet 1

Serial Number on file for your tablet (please confirm).

Tablet 1

LL License ID

Tablet 2

Serial Number on file for your tablet (please confirm).

Tablet 2

Serial Number on file for your tablet (please confirm).

Tablet 2

Serial Number on file for your tablet (please confirm).

Tablet 2

Serial Number on file for your tablet (please confirm).