Sunrise Medical QUICKIE F55 - Manual (Page 67)

65 Issue 7
YEAR 1 2 3 4
Service dates
Upholstery
Seat
Back
Armrests
Electrics
Condition
of loom
Connections
Lights (where
fitted)
Test run
Forwards
Reverse
Emergency
stop
Left turn
Right turn
Up/down slope
Over obstacle
Parking brake
(where fitted)
List items repaired/adjusted
YEAR 1 2 3 4
Service dates
Controller
On/off switch
Output plug
Operation
Dynamic braking
Programmable
settings
Batteries
Levels
Connections
Discharge test
Wheels/tyres
Wear
Pressure
Bearings
Wheel nuts
Motors
Wiring
Noise
Connections
Brake
Brushes
Chassis
Condition
Steering
Customer Name
Address
Postcode
Service history
Date chair purchased
Model
Colour
Serial No.
Dealer stamp
Date: Signed :
Dealer stamp
Date: Signed :
Dealer stamp
Date: Signed :
Dealer stamp
Date: Signed :
This section is designed to assist you in keeping a record of any service and repairs to your wheelchair. Should
you decide to sell or exchange your vehicle in the future, this will prove most helpful to you. Your Service Agent
will also benefit from a documented record and this manual should accompany the wheelchair when service or
repair work is carried out. The Service Agent will complete this section and return the manual to you.