Flu Clinic Operations Checklist Form
Complete this checklist to track daily operational tasks for the flu clinic. This form is for internal operational use only.
Date of Operations
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Clinic Location
*
Shift Supervisor Name
*
First Name
Last Name
Opening Checklist
*
Signage in place
Supplies restocked
Waiting area set up
Workstations sanitized
Other
Supplies Inventory Status
*
All supplies available
Some supplies low
Restock needed
Cold Storage Temperature (°C)
*
Incident or Issue Reported?
*
No incidents
Yes (details below)
Comments or Notes
Task Completion Confirmation
*
Submit Checklist
Submit Checklist
Should be Empty: