Pharmaceutical Cold Chain Audit Form
Complete this audit to ensure compliance with pharmaceutical cold chain storage and handling requirements.
Audit Location/Facility Name
*
Auditor Full Name
*
First Name
Last Name
Audit Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Storage Equipment Identification (e.g., Fridge/Freezer Serial Number)
*
Type of Storage Equipment
*
Please Select
Refrigerator
Freezer
Cold Room
Temperature-Controlled Vehicle
Other
Current Temperature (°C)
*
Is the temperature within the required range for this equipment?
*
Yes
No
Temperature Monitoring and Alarm System Status
*
Continuous temperature monitoring active
Alarm system functional
Alarm tested during audit
Data logger in use
Other
Date of Last Equipment Calibration/Maintenance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Audit Findings: Please indicate compliance for each item below.
*
Rows
Compliant
Non-Compliant
Not Applicable
Temperature logs up to date
1
2
3
No signs of temperature excursions
4
5
6
Products stored off the floor and away from walls
7
8
9
No expired products present
10
11
12
Backup power available
13
14
15
Corrective action procedures displayed
16
17
18
Were any deviations or temperature excursions observed? If yes, please describe.
*
Corrective Actions Taken (if applicable)
Overall Cold Chain Compliance Rating
*
1
2
3
4
5
Auditor Signature (Please sign below to confirm the accuracy of this audit)
*
Submit Audit
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