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Sample Incomplete Biological Result Form

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Lakeland (Fla.) Surgical & Diagnostic Center has staff members fill out a form whenever implantable devices and trays have not completed their biological monitor result.



This form also asks why the release of the devices and trays was necessary and what could have prevented the premature release.


Upon the form's completion, it is returned to the sterile processing department.


To download a sample copy of the incomplete biological result form you can adapt for use in your ASC, click here (doc).


Learn more about Lakeland Surgical & Diagnostic Center.


Download other sample forms for adaptation and use in your ASC:


- Sample Wound Infection/Unexpected Outcome Report


- Sample ASC Discharge Criteria Policy


- Sample ASC Time-Out Policy and Procedure

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