Urgent Care Equipment Maintenance Log

Daily, Weekly, and Monthly Equipment Inspection and Maintenance Documentation

Urgent Care

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Last updated: Mar 24, 2025

Equipment Information

Equipment Name: _______________
Model Number: _________________
Serial Number: ________________
Location: _____________________

Daily Checks

Date Time Visual Inspection Functionality Test Cleaning/Sanitization Staff Initials Notes

Weekly Maintenance

Week of: _______________

  • Calibration check (if applicable)
  • Battery check/replacement
  • Software updates verified
  • Safety features tested
  • Accessories inventory

Technician: _________________
Date Completed: _____________

Monthly Service Record

Month: _______________

Preventive Maintenance:

  • Deep cleaning performed
  • Parts inspection completed
  • Performance testing done
  • Safety certification verified
  • Manufacturer guidelines reviewed

Service Details:

  • Parts replaced: _________________
  • Repairs made: __________________
  • Next service due: ______________

Equipment Issues Log

Date Issue Description Action Taken Resolved (Y/N) Follow-up Required Staff Member

Annual Certification

Last Certification Date: ____________
Next Certification Due: ____________
Certifying Agency: ________________

Contact Information

Equipment Manufacturer: _____________
Service Provider: __________________
Emergency Contact: ________________

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