Electronic Device Acknowledgment Form

The Host Must:

• Maintain observation of electronic devices in use to ensure compliance.
• Ensure electronic devices are not connected to any Laboratory devices without specific authorization from SSD.
• Ensure no photography or audio/video use or recording occurs within the Laboratory.
• Follow Laboratory policy ISS-2.3.5 (Wireless and mobile devices).

The Visitor must:

• Follow all Laboratory policies.
• Follow guidance provided by the Laboratory host.
• Notify the host of any medical devices present.
  • This form is not inclusive of medical devices, which require separate approval.

For any wireless and mobile device usage questions, please call ext. 1291.

I have read the above information and understand and agree to my responsibilities.