General Information Device Name/Model Number * Manufacturer Name * Manufacturing Address: * Country of Origin * Date Of Manufacturer * Device Serial Number: * Intended Use (Clinical, Research, etc.) * ID Proof of the Owner, Author. * Choose FileNo file chosenDelete uploaded file Technical Specifications Number of Channels: * Battery Life/Power Source * Data Output Format (e.g., EDF, CSV) * Supported Operating Systems * Connectivity Options (e.g., USB, Bluetooth, Wi-Fi) *USBBluetoothWi-Fi Safety and Compliance Hazard Identification (List any known risks) * Safety Features * Performance Testing Clinical Test Results Available *YesNo Validation Studies Performed *YesNo Reliability Studies or Reports *YesNo Clinical Applications Tested *YesNo Documentation User Manual Attached *YesNo Technical Support Contact Details *YesNo Software Version/Updates *YesNo Training Material for Users Provided *YesNo Warranty Information *YesNo Self Attested letter for Ownership, authorship of their products * Choose FileNo file chosenDelete uploaded file Additional Comments/Notes * Declaration and Signature Name * Position/Title: * Company Email Address * Phone * Date * Signature Choose FileNo file chosenDelete uploaded file Submit
