Free Medical Equipment Checklist

Prepared by: [Your Name]
Date: October 10, 2050
I. Equipment Identification
Equipment Name: | Defibrillator |
Model Number: | Lifepak 15 |
Manufacturer: | Physio-Control |
Serial Number: | 123456789 |
Location: | Emergency Room |
II. Condition Assessment
Functional Status:
Functional
Needs Repair
Out of Service
Last Maintenance Date: April 15, 2050
Next Maintenance Due October 15, 2050
III. Quantity Verification
Required Quantity: 2
Available Quantity: 2
Shortage:
Yes
No
IV. Preparation Notes
Setup Instructions:
Clean and sterilize
Calibrate if necessary
Test functionality
Special Considerations:
Ensure batteries are charged
Verify attachments and accessories
V. Sign-off Section
Prepared By:
[Your Name]
Reviewed By:

Johann Harvey
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Maintain the accuracy and readiness of your medical devices with the Medical Equipment Checklist Template from Template.net. This editable and customizable template is designed to help healthcare professionals keep track of medical equipment maintenance and functionality. Editable in our AI Editor Tool, it can be personalized to suit any healthcare facility’s needs.
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