Optical Disc Condition Assessment Form
Use this form to record the condition, readability, visible wear, storage history, and overall assessment of an optical disc.
Disc Identification and Inspection Setup
Disc identifier or catalog reference code
*
Disc format/type
*
CD
DVD
Blu-ray
Other
Disc label/title
Inspection date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector name or initials
*
Condition Assessment and Findings
Surface Condition Rating
*
1
2
3
4
5
Readability / Playback Status
*
Readable
Partially Readable
Not Readable
Not Tested
Visible Issues
Scratches
Scuffs
Cracks
Warping
Label Damage
Discoloration
Contamination
None Observed
Remarks / Notes
Storage History and Overall Result
Storage Environment and History
*
Overall Assessment Outcome
*
Acceptable
Needs Cleaning
Needs Repair/Recovery
Replace/Retire
Final Comments and Recommended Next Steps
Submit Assessment
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