Maintenance Reports - Abbotsford Private Hospital

Maintenance Reports & Requests

Use this form to report any maintenance issue- even if it has been fixed.

Include your name and email so we can double-check information with you if needed.

A separate report is needed for each item so that the maintenance issues can be managed and reported correctly.

Has this item been fixed? *

YesNo

Type of Maintenance Issue *

PreventativeScheduledImportantUrgent

Date of Report *

First Name *

Last Name *

Email Address *

Patient Rooms

Clinical Areas

General Area

Administration Area

Service Area

What is the identified issue?

Further information if required

Reviewed Date

Priority Assigned *

PreventativeScheduledImportantUrgent

Status

CompletedIn ProgressWaiting on anotherNo action required

Estimated Date for Completion *

Influencing Factors & Recommendations

Minor job- can be/ has been completed inhouseMedium job- can be / has been completed inhouseRequires isolation of areaRequires people to be relocatedRequires a repair quoteRequires external partsRequires external contractorRequires extra time to be scheduled