Equipment assessment

This form maps the equipment you have on site against continuous monitoring. It takes about fifteen minutes. Nothing is required except an email address — leave blank anything you do not know, and you can come back to this page later: your answers are saved as you type.

No patient information. This form asks about equipment only. Do not enter patient names, medical record numbers, or any clinical data.

1. Your facility

So we know who we are talking to.

Facility name

City

State

Licensed beds

CCN (optional)

Your name

Your role

Email *

Phone

2. Equipment

One block per type of equipment. Add as many as you need. If you are unsure of a model or an age, leave it blank — it is not required.

3. How it is checked today

This is the part that tells us the most.

Who reads the temperatures or gauges?

How often?

Nights, weekends and holidays?

We lost stock, product or samples in the last twelve months

If yes, what happened?

4. What you are audited against

Check anything that applies to your site.

Vaccines for Children (VFC) program

CLIA laboratory certification

Blood bank / AABB

USP 797 / 800 compounding

Joint Commission or other accreditation

State health department survey

Anything else

5. Site and support

Internet at the facility

Cellular coverage in the building

Who maintains this equipment?

Anything else we should know

6. Before you send

You may contact me about this assessment. I understand no equipment is modified and nothing is installed at this stage.

You will receive a written summary of what you listed, including the equipment that continuous monitoring would not cover. It is yours to keep whether or not you work with us.