Hospital Medical Equipment Energy Audit Checklist
Audit Date
Auditor Name
Department / Area
Equipment Name
Model / Serial No.
Quantity
Rated Power (Watt)
Operating Hours / Day
Days / Month
Estimated Monthly Energy Consumption (kWh)
Operational Status
Comments / Actions
In Use
Idle
Out of Order
In Use
Idle
Out of Order
In Use
Idle
Out of Order
Overall Observations / Recommendations
Auditor Signature