D.med NephroFlow Training Checklist Ver 1.0

Hospital:

Name of Trainee

Date / Signature

Identify device operating buttons Confirm correct mode (Quick or Normal) Select correct patient Enter new patient data correctly Attach sensors to bloodlines correctly Confirm that sensors have an acceptable signal Select Access Flow Measurement; follow instructions and observe/interpret results Select Recirculation Measurement; follow instructions and observe/interpret results Document results and report abnormalities Retrieve results in Report menu Switch from battery to plug-in mode (if applicable) Charge the battery pack correctly (if applicable)

I hereby confirm that I have demonstrated the correct and safe use of the D.Med NephroFlow device and that I have observed the Trainee(s) demonstrate the correct and safe use of said device. Nipro Clinical Application Specialist: Trainer Signature: Date: