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Surgical Equipment Maintenance Documentation Template

Comprehensive Equipment Tracking and Maintenance Log for General Surgery Practices

General Surgery

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Last updated: Mar 24, 2025

Equipment Information

  • Equipment Name/Model: ________________
  • Serial Number: ________________
  • Location: ________________
  • Manufacturer: ________________
  • Purchase Date: ________________
  • Warranty Expiration: ________________

Maintenance Schedule

Date Maintenance Type Next Due Date
□ Routine Inspection
□ Calibration
□ Sterilization Check
□ Safety Testing

Service Record

Maintenance Details

  • Date of Service: ________________
  • Technician Name: ________________
  • Service Type: □ Preventive Maintenance □ Repair □ Calibration □ Other: ________________

Work Performed

  • Description of Service: ________________
  • Parts Replaced: ________________
  • Cost: ________________
  • Invoice Number: ________________

Quality Assurance

  • Tested After Service: □ Yes □ No
  • Performance Verified By: ________________
  • Date: ________________

Notes

Emergency Contacts

  • Manufacturer Support: ________________
  • Service Provider: ________________
  • Biomedical Department: ________________

Maintain this log in compliance with facility policies and regulatory requirements.

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