Run Supercenter Vision Center Equipment Calibration Log — Free

Inspection Details

Inspection date and time recorded critical (required)

Store or vision center location identified critical (required)

Inspector name and role documented critical (required)

Applicable equipment SOP or calibration reference available

General Readiness and Safety

Work area clean, dry, and free of obstructions around equipment critical (required)

Yes No N/A

Power cords, plugs, and visible cables show no damage or trip hazard critical (required)

Yes No N/A

Equipment surfaces and patient-contact areas cleaned and disinfected per SOP critical (required)

Yes No N/A

Required PPE available for cleaning or adjustment tasks

Auto-Refractor Verification

Auto-refractor powers on and completes startup without error critical (required)

Yes No N/A

Calibration check passes using manufacturer or internal reference target critical (required)

Yes No N/A

Displayed measurement values are within acceptable tolerance critical (required)

Lens port, chin rest, and forehead rest are clean and unobstructed

Yes No N/A

Lensometer Verification

Lensometer powers on and zero/reference check completes successfully critical (required)

Yes No N/A

Sphere and cylinder readings verified against calibration lens critical (required)

Yes No N/A

Axis alignment indicator is stable and readable

Yes No N/A

Lens stage, eyepiece, and contact surfaces are clean

Yes No N/A

Slit Lamp and Tonometer Verification

Slit lamp powers on and illumination controls function across settings critical (required)

Yes No N/A

Slit lamp optics, joystick, and patient support surfaces are clean and functional

Yes No N/A

Tonometer powers on and self-check completes without fault critical (required)

Yes No N/A

Tonometer calibration or test verification is within acceptable range critical (required)

Deficiencies and Sign-Off

Any deficiencies, non-conformances, or out-of-tolerance results documented critical (required)

Yes No N/A

Equipment removed from service when calibration or function check failed critical (required)

Yes No N/A

Corrective action owner and expected completion time recorded

Inspector signature critical (required)

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Run: Supercenter Vision Center Equipment Calibration Log

Inspection Details

General Readiness and Safety

Auto-Refractor Verification

Lensometer Verification

Slit Lamp and Tonometer Verification

Deficiencies and Sign-Off

Get your results