Patient Transfer Equipment Inspection Checklist
Complete this checklist before using patient transfer equipment to ensure safety and readiness.
Equipment/Item Name
*
Equipment Type
*
Please Select
Stretcher
Wheelchair
Patient Lift
Transfer Board
Other
Asset/Equipment ID (if applicable)
Equipment Location
*
Inspection Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Inspector Name
*
First Name
Last Name
Inspector Role
*
Condition/Status of Key Components
*
Frame intact
Wheels/casters secure
Brakes functional
Straps/belts present and intact
Handles secure
Other (describe below)
Cleanliness/Sanitation Status
*
Clean and sanitized
Requires cleaning
Unsure
Safety/Function Checks Completed
*
Passed
Failed
Any Missing or Damaged Parts?
*
No
Yes (describe below)
Battery/Charge Status (if applicable)
*
Fully charged
Partially charged
Needs charging
Not applicable
Final Pass/Fail Determination
*
Pass
Fail
Notes and Follow-up Actions
Submit Inspection
Should be Empty: