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CT Service Training Request

Training Request Form

Name*
First Last
Email*
Phone
Company Name*
Business Type*
- Independent Service Provider
- Hospital/Clinical Engineering
- N/A
Please select training course*
- Fort Mill, SC – USA: Toshiba Aquilion 16-slice CT
- Fort Mill, SC - USA: Toshiba Aquilion 32/64-slice CT
- Fort Mill, SC - USA: VeloCT Platform
- Fort Mill, SC – USA: Toshiba Aquilion PRIME CT
Starting Date - Option #1*
MM slash DD slash YYYY

Please provide us with two training date options and we will work with to accommodate to accommodate your schedule .
Starting Date - Option #2*
MM slash DD slash YYYY

Please provide us with two training date options and we will work with to accommodate to accommodate your schedule .
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704.739.3597 ext. 3

healthcare@rell.com

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