CPAP Maintenance Checklist
Track routine care and readiness of CPAP equipment with this maintenance checklist.
Date of Maintenance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Person Responsible
*
First Name
Last Name
CPAP Filter Checked and Cleaned/Changed
*
Completed
Not Applicable
Tubing/Hose Inspected for Damage or Blockages
*
No Issues Found
Replaced
Not Applicable
Mask Cleaned and Inspected for Wear
*
Cleaned and OK
Replaced
Not Applicable
Humidifier Chamber Cleaned and Checked for Cracks
*
Cleaned and OK
Replaced
Not Applicable
Power Supply and Cords Checked for Safety
*
Safe and Functional
Replaced
Not Applicable
Device Turned On and Functionality Tested
*
Operational
Requires Service
Backup Supplies Available (Filters, Masks, Tubing)
*
Sufficient
Need to Order
General Notes or Observations
Submit Checklist
Should be Empty: