Automatic Door Inspection Checklist
Use this form to inspect the condition, operation, safety features, and maintenance needs of an automatic door.
Inspection Details
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Time
*
Hour Minutes
AM
PM
AM/PM Option
Site or Facility Name
*
Exact Door Location
*
Door Identification / Asset Tag
*
Inspector Name
*
First Name
Middle Name
Last Name
Inspector Role or Department
Door Type
*
Please Select
Sliding
Swinging
Revolving
Folding
Other
Inspection Notes
Operational Check
Power Status
*
On
Off
Sensor Activation
*
Pass
Fail
Opening/Closing Smoothness
*
1
2
3
4
5
Timing Response
*
1
2
3
4
5
Obstruction Detection
*
Pass
Fail
Manual Override Function
Pass
Fail
Not Applicable
Emergency Breakaway or Fail-Safe Behavior
Pass
Fail
Not Applicable
General Operational Condition
*
1
2
3
4
5
Operational Defects Notes
Safety and Physical Condition
Condition of Glass/Panels
*
Good
Minor Wear
Damaged
Not Applicable
Frame Condition
*
Good
Minor Wear
Damaged
Not Applicable
Tracks or Hinges Condition
*
Good
Minor Wear
Damaged
Not Applicable
Seals / Weather Stripping Condition
Good
Minor Wear
Damaged
Not Present
Signage and Warnings Present and Clear
*
Yes
No
Partial
Not Applicable
Floor Area Around Door Safety
*
1
2
3
4
5
Debris or Obstructions Observed
None
Small Debris
Obstruction Present
Slippery Surface
Other
Hazards Identified
Overall Safety Compliance Status
*
Compliant
Partially Compliant
Non-Compliant
Maintenance and Follow-up
Corrective Action Required
*
Yes
No
Priority Level
*
Please Select
Low
Medium
High
Urgent
Recommended Action / Repair Description
Parts Needed
Estimated Completion Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Follow-up Responsible Party
Final Inspection Result
*
Please Select
Pass
Pass with Issues
Fail
Needs Reinspection
Overall Comments
Submit Inspection
Should be Empty: