Arkray Assure PRISM MULTI - Certified Instructor Training Record

SECTION
E
33
CERTIFIED INSTRUCTOR TRAINING RECORD
ASSURE
®
PRISMMULTIBLOODGLUCOSEMONITORINGSYSTEM
ThehealthcareprofessionalslistedbelowhavebeentrainedtoserveasCertiedTrainers
for the Assure® PrismmultiBloodGlucoseMonitoringSystem.Theyarequaliedtoperform
initialtrainingofcertiedoperations,conductperformancereviews,andmaintainrecords
concerningCertiedOperators.
ARKRAY Representative Name ______________________________________________
To be used during the initial training on the Assure Prism multi Blood Glucose Monitoring
System by an ARKRAY Representative within the facility.
TobekeptonleintheNursingUnitandupdatedbyCertiedTrainer.
Date Healthcare Professional’s Name Title Recertification Date
Name of facility:
Minneapolis, MN 55439 USA
TEL 800.818.8877
FAX 952.646.3110
www.arkrayusa.com