Operating Room Climate Log Form
Use this form to log and monitor environmental conditions in the operating room.
Date and Time of Log
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Operating Room Number or Identifier
*
Temperature (°C)
*
Humidity (%)
*
Air Pressure (Pa)
Logged By (Name)
*
First Name
Last Name
Shift
Please Select
Morning
Afternoon
Night
Additional Comments
I confirm the above information is accurate
*
Yes, I confirm
Submit Log
Should be Empty: