Equipment Maintenance Usage Assessment Form
Please complete the Equipment Maintenance Usage Assessment Form to help us evaluate how equipment is being used and maintained. Your feedback will support improvements in our maintenance practices.
Equipment Name or ID
*
Department or Location
*
How frequently is this equipment used?
*
Daily
Several times per week
Weekly
Monthly
Rarely
How often is maintenance performed on this equipment?
*
After every use
Weekly
Monthly
Quarterly
As needed
Rate the current condition of the equipment.
*
1
2
3
4
5
Please indicate your level of agreement with the following statements about equipment maintenance.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Maintenance procedures are clearly documented.
1
2
3
4
5
I have received adequate training on equipment maintenance.
6
7
8
9
10
Maintenance logs are kept up to date.
11
12
13
14
15
Spare parts and tools are readily available.
16
17
18
19
20
Have you experienced any issues or breakdowns with this equipment in the past 6 months?
*
Yes
No
If yes, please describe the issue(s) and how they were resolved.
Overall, how satisfied are you with the maintenance process for this equipment?
*
1
2
3
4
5
Additional comments or suggestions
Submit Assessment
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