Biological Indicator Evaluation Form
Please complete all sections to record the evaluation of a biological indicator. This form is for quality control documentation only.
Evaluator Name
*
First Name
Last Name
Lab/Department or Contact Email
*
Sample or Load Identifier
*
Sterilizer or Load Type
*
Please Select
Steam Autoclave
Ethylene Oxide (EtO)
Hydrogen Peroxide
Dry Heat
Other
Biological Indicator Type
*
Please Select
Geobacillus stearothermophilus
Bacillus atrophaeus
Other
Process/Cycle Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Incubation Start Date & Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Incubation Temperature (°C)
*
Observation/Result
*
No Growth (Negative)
Growth Detected (Positive)
Invalid/Control Failure
Pass/Fail Assessment
*
Pass
Fail
Submit Evaluation
Should be Empty: