Medical Device Sterilization Maintenance Sheet
Device Name
Model/Serial No.
Department/Location
Date of Sterilization
Sterilization Method
Operator Name
Device Condition & Maintenance
Pre-sterilization Inspection
Post-sterilization Inspection
Was device cleaned before sterilization?
Yes
No
Were indicators used?
Yes
No
Indicator Result
Comments/Observations
Maintenance Record
Date
Description
Technician
Remarks
Supervisor Signature
Date