Chiropractic Equipment Maintenance and Safety Log

Equipment Information

Equipment Name: _______________
Model Number: _________________
Serial Number: ________________
Purchase Date: ________________
Warranty Expiration: ___________

Daily Inspection Checklist

• Equipment surfaces cleaned and sanitized
• Moving parts operate smoothly
• Safety features functional
• No visible damage or wear
• Electrical connections secure (if applicable)

Monthly Maintenance Record

Calibration Schedule

Last Calibration Date: ____________
Next Calibration Due: ____________
Calibration Company: ____________

Repair History

Repair Log

• Date: ________
  • Issue: ________________
  • Resolution: ____________
  • Cost: ________________
  • Service Provider: ______

Safety Incident Record

• Date: ________
  • Incident Description: _____
  • Action Taken: ___________
  • Follow-up Required: ______

Annual Safety Certification

Last Certification Date: __________
Next Certification Due: __________
Certifying Body: _______________

Notes

Maintain this log for each piece of equipment in accordance with state regulations and manufacturer guidelines.