Concierge Practice Equipment Maintenance Log

Comprehensive Documentation Template for Medical Equipment Tracking

Concierge Medicine

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Template Content

Last updated: Mar 24, 2025

Equipment Information

Equipment Name: _______________ Model Number: ________________ Serial Number: ________________ Location: _____________________ Purchase Date: ________________

Maintenance Schedule

  • Daily Checks Required: □ Yes □ No
  • Weekly Checks Required: □ Yes □ No
  • Monthly Checks Required: □ Yes □ No
  • Quarterly Service Required: □ Yes □ No
  • Annual Certification Required: □ Yes □ No

Maintenance Record

Date Service Type Performed By Details Next Due Date

Calibration Record

Date Calibration Type Performed By Results Next Due Date

Issue Log

Date Issue Description Action Taken Resolution Date Follow-up Required

Annual Review

Year: ________

  • Equipment Status: □ Operational □ Needs Replacement □ Under Review
  • Maintenance Costs This Year: $_________
  • Recommended Actions: _________________
  • Review Performed By: _________________
  • Date: _______________

Safety Compliance

  • Last Safety Inspection Date: ____________
  • Safety Certification Expiry: ____________
  • Safety Protocols Review Date: __________

Notes




Keep this log updated and readily available for inspections and audits

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