Stryker Operating Room Information System User Manual

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B.2 Network Connectivity Questionnaire (Response Required)
Note is form is intended for use only when installing Stryker equipment on a customer's network.
Instructions: Customer IT department must complete this form with assistance from Stryker Project Manager and Engi-
neers (Stryker personnel must enter number of static IP addresses required for ORIS install and for local CODECs before
providing this form to the customer, at a minimum). Accurate completion of this form is required for installation. Do not
use this form for ConnectSuite.
FACILITY _____________________________________________________________________
CUSTOMER PROJECT MGR._____________________________________________________
TELEPHONE: ____________________________EXTENSION: __________________________
HOURS: ________________________TARGET INSTALL TIME FRAME: _________________
E-MAIL _______________________________________________________________________
ORIS
At peak usage, what percentage of total internal bandwidth is used? _________________________________
Primary manufacturer of network switches: ___________________________ Other: __________________
Number of Static IP addresses required for ORIS install: _________________ ___________________
Subnet Mask: ____________________ Default Gateway: ____________________
Videoconferencing (ll in this section if installing a Polycom)
Is there a Videoconferencing (VC) network subnet separate from the primary network?__________________
How much total bandwidth is available on your separate VC network? _______________________________
What percentage of your VC network bandwidth do you currently use? ______________________________
Do CODECs associate with an H.323 Gatekeeper (aka Session Border Controller)? _____________________
If this institution works with a bridging service, please provide the information below:
Company name: ____________ POC name: _____________ POC phone/email: ______________
Number of IP Addresses required for local CODECs (Polycom): _________________________________
Range of IP Addresses Reserved for local CODECs: ___________________ to ______________________
Subnet Mask: ____________________ Default Gateway: ___________________________
If E.164 IDs are not auto-assigned by an H.323 Gatekeeper, please provide reserved E.164 IDs: (for each
Polycom)
___________________ ___________________ ___________________ ___________________
I acknowledge the above information submitted us accurate to the best of my knowledge.
Institution Representative Printed Name Title
Institution Representative Signature Title

Stryker Operating Room Information System Specifications

General

Brand	Stryker
Model	Operating Room Information System
Category	Medical Equipment
Language	English