Laboratory Audit Pathology Assessment Form
Use this form to systematically assess and document compliance with pathology laboratory standards and procedures.
Audit Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Auditor Full Name
*
First Name
Last Name
Auditor Email Address
*
example@example.com
Laboratory/Facility Name
*
Department/Section Assessed
*
Assessment of Pathology Laboratory Compliance
*
Rows
Compliant
Partially Compliant
Non-Compliant
Not Applicable
Sample Collection and Labeling
1
2
3
4
Specimen Transport and Storage
5
6
7
8
Equipment Maintenance and Calibration
9
10
11
12
Documentation and Record Keeping
13
14
15
16
Safety and Biohazard Protocols
17
18
19
20
Staff Training and Competency
21
22
23
24
Quality Control Procedures
25
26
27
28
Reporting Accuracy and Timeliness
29
30
31
32
Overall Laboratory Compliance Rating
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Observed Deficiencies or Areas for Improvement (if any)
Recommendations for Corrective Action
Additional Comments
Auditor Signature
*
Submit Assessment
Submit Assessment
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