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Campaign - Decontamination of Medical Devices

Page 23

Appendix 2 – Sample certificate

CERTIFICATE OF DECONTAMINATION Type of device

Model

Manufacturer

Serial no

Inventory number

Method of decontamination Please tick appropriate box Cleaning

Cleaning followed by disinfection

Other (please specify)

Decontaminated by

on

Inspected and packaged by

on

Site location Notes

This item has been prepared to ensure safe handling and transportation Name Position Signature Tel

The BHTA guide to Decontamination of Medical Devices and other Assistive Technology

21

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