Home Appliance Resistance Testing Form
Please complete this form to record the results of resistance testing for home appliances. Ensure all information is accurate and complete.
Appliance Type
*
Please Select
Washing Machine
Refrigerator
Dishwasher
Oven
Microwave
Air Conditioner
Heater
Other
Brand and Model
*
Serial Number
*
Location of Appliance
*
Date of Test
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Test Method Used
*
Please Select
Insulation Resistance Test
Earth Continuity Test
Leakage Current Test
Other
Measured Resistance Value (Ohms)
*
Test Result
*
Pass
Fail
Technician Name
*
First Name
Last Name
Technician Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Notes or Observations
Upload Test Report or Photos (if available)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Client/Owner Name
First Name
Last Name
Client/Owner Email Address
example@example.com
Submit Test Report
Should be Empty: