MEDICAL EQUIPMENT CALIBRATION CHECKLIST

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--- EQUIPMENT IDENTIFICATION & INFORMATION ---
[ ] Equipment Name
[ ] Manufacturer
[ ] Model Number
[ ] Serial Number
[ ] Asset/Equipment Tag Number
[ ] Date of Installation/Commissioning
[ ] Equipment Location (Room/Department)
[ ] Equipment Status (Operational, Awaiting Repair, Out of Service) (Operational, Awaiting Repair, Out of Service)

--- CALIBRATION SCOPE & STANDARDS ---
[ ] Equipment Name/Model
[ ] Serial Number/Asset Tag
[ ] Calibration Parameters (Accuracy, Precision, Linearity, Resolution, Repeatability, Sensitivity)
[ ] Calibration Standard Used (NIST traceable, ISO 17025 accredited lab, Manufacturer's Standard, Other (Specify))
[ ] Specify Calibration Standard (If 'Other')
[ ] Acceptance Criteria Tolerance (%)
[ ] Date Standard Valid Until
[ ] Upload Calibration Standard Certificate

--- PRE-CALIBRATION CHECKS & ASSESSMENT ---
[ ] Date of Pre-Calibration Check
[ ] Equipment Name/Model
[ ] Equipment Serial Number
[ ] Visual Inspection Notes (Damage, Leaks, Wear)
[ ] Initial Reading (Parameter 1) - As Found
[ ] Initial Reading (Parameter 1) - Unit
[ ] Equipment Functionality - Pre Calibration (Operational, Limited Functionality, Non-Operational)
[ ] Any Concerns/Issues Noted Before Calibration

--- CALIBRATION PROCEDURE ---
[ ] Step 1: Power On and Warm-Up
[ ] Step 2: Ambient Temperature (Â°C)
[ ] Step 2: Ambient Humidity (%)
[ ] Step 3: Selected Calibration Mode (e.g., Auto, Manual) (Auto, Manual, Other (Specify))
[ ] Step 4: Describe any specific setup required for calibration.
[ ] Step 12: Input 1 value (Units)
[ ] Step 21: Input 2 value (Units)

--- CALIBRATION RESULTS ---
[ ] Measured Value 1 (e.g., Temperature)
[ ] Measured Value 2 (e.g., Pressure)
[ ] Measured Value 3 (e.g., Volume)
[ ] Uncertainty of Measurement (Value 1)
[ ] Uncertainty of Measurement (Value 2)
[ ] Uncertainty of Measurement (Value 1)
[ ] Pass/Fail Status (Pass, Fail, Marginal)
[ ] Notes/Comments on Results

--- ADJUSTMENT & CORRECTION ---
[ ] Detailed Description of Adjustments Made
[ ] Adjustment Value (e.g., % or units)
[ ] Initial Reading Before Adjustment
[ ] Final Reading After Adjustment
[ ] Adjustment Method Used (Software Adjustment, Mechanical Adjustment, Internal Configuration, Other (Specify in LONG_TEXT))
[ ] Justification for Adjustment (if applicable)
[ ] Was Tolerance Achieved? (Yes, No)
[ ] Reason for Not Achieving Tolerance (if applicable)
[ ] Signature of Technician Performing Adjustment
[ ] Date of Adjustment

--- POST-CALIBRATION VERIFICATION ---
[ ] Verification Measurement 1 (Value)
[ ] Verification Measurement 1 (Units)
[ ] Verification Measurement 2 (Value)
[ ] Verification Measurement 2 (Units)
[ ] Verification Result: Within Tolerance? (Yes, No)
[ ] Notes on Verification (if applicable)
[ ] Date of Verification
[ ] Time of Verification

--- DOCUMENTATION & REPORTING ---
[ ] Calibration Certificate (Uploaded)
[ ] Review of Certificate: Completeness & Accuracy
[ ] Certificate Validity? (Valid, Invalid)
[ ] Notes/Comments on Certificate Review (if applicable)
[ ] Date of Certificate Review
[ ] Reviewer Signature

--- CALIBRATION SCHEDULE & FOLLOW-UP ---
[ ] Date of Last Calibration
[ ] Next Calibration Due Date
[ ] Calibration Interval (in months/years)
[ ] Calibration Performed By (Internal/External) (Internal, External)
[ ] Notes/Comments Regarding Calibration Schedule & Follow-up
[ ] Calibration Status (Not Started, In Progress, Completed, Overdue)
[ ] Date Calibration Reminder Sent

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