Telemedicine Platform Audit Form
Please complete the audit form for the telemedicine platform.
Auditor Full Name
First Name
Last Name
Audit Date
-
Month
-
Day
Year
Date
Platform Name
Platform Version
Compliance with Regulations
Fully Compliant
Partially Compliant
Non-Compliant
Security Measures Implemented
User Experience Rating
1
2
3
4
5
Any Issues or Concerns
Recommendations
Submit
Should be Empty: