Location of Trade in

Office/Dr Name
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City
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  • Select State
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Select State
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Expected install of new equipment:
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Product to Trade in

Manufacturer
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Model #
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Serial #
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Year of Manufacture
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Dr's Phone #
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Photos

Front...
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Back...
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Side 1...
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Side 2...
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Side 3...
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Serial Plate...
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Accessories...
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Accessories 1...
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Working

Working
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Comments...
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