Surgical Center Clinic Design Checklist Form
Use this form to review and document design requirements, project status, and key checklist items for your surgical center or clinic planning.
Facility Name
*
Project Status
*
Please Select
Planning
Design Development
Under Construction
Completed
Clinic Layout and Room Types (Select all that apply)
*
Reception/Waiting Area
Consultation Rooms
Operating Rooms
Recovery Rooms
Sterilization Area
Other
Workflow Design Considerations
Separate patient and staff circulation
Clear signage and wayfinding
Efficient patient flow
Dedicated supply routes
Other
Safety Features Checklist
Emergency exits clearly marked
Fire alarms and extinguishers
Non-slip flooring
Hand hygiene stations
Other
Essential Equipment and Utilities
Medical gas outlets
Backup power supply
Sterilization equipment
Waste disposal systems
Other
Accessibility Features
Wheelchair accessible entrances
Accessible restrooms
Elevator access
Braille signage
Other
Compliance and Regulatory Considerations
Local building codes
Fire safety regulations
Accessibility standards
Infection control guidelines
Other
Describe any specific design requirements or preferences
Additional Comments or Notes
Submit Checklist
Should be Empty: