DA Form 5621-R. Medical Equipment Electrical Safety

DA Form 5621-R is a document used to ensure the electrical safety of medical equipment.

The form consists of sections where information about medical equipment, its electrical safety inspection details, and any identified issues are recorded. It serves to assess and document the electrical safety of medical equipment, ensuring compliance with safety standards.

Key fields in this form include equipment identification, inspection details, and any safety concerns identified. Accurate completion of this form is crucial for maintaining the safety and functionality of medical equipment used in healthcare settings.

Application Example: A biomedical technician performs an electrical safety inspection on medical equipment and completes DA Form 5621-R to document the inspection results. By accurately recording inspection details and addressing any identified issues, the form aids in maintaining safe medical equipment for patient care.