Printer Maintenance Assessment Form
Evaluate the current status and maintenance needs of your printer.
Printer Model/ID
*
Location of Printer
*
Printer Operational Status
*
Fully operational
Operational with minor issues
Partially operational
Not operational
Date of Last Maintenance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Common Issues Observed (select all that apply)
*
Paper jams
Print quality issues
Connectivity problems
Unusual noises
Frequent error messages
None
Other
Supplies/Consumables Status
*
Rows
Full
Low
Empty
Toner/Ink
1
2
3
Paper
4
5
6
Maintenance Kit
7
8
9
Waste Container
10
11
12
Are there any current error messages displayed?
*
No error messages
Yes (please specify below)
If yes, specify the error message(s):
Printer Cleanliness Rating
*
1
2
3
4
5
Additional Comments or Recommendations
Submit
Should be Empty: