Authorised Signatures & Initials Log template
A log in the Personnel, Training and Competence procedure (PR12), mapped to ISO 15189:2022 clause 6.2. Fill it in monthly. Used by the quality-management team.
LogISO 15189 · 6.2Monthly
Calculated automaticallyRed = outside limits
Your LaboratoryAuthorised Signatures & Initials Log | YL-QM-LOG-12-F10 v1.0
Record: Authorised Signatures & Initials Log — October 2026
SectionHaematology
Year2026
| No. | Full Name | Designation | Employee No. | Authorized From | SPECIMEN OF SIGNATURE | Specimen of Initials | Date Verified | Verified by | Comments |
|---|---|---|---|---|---|---|---|---|---|
| 1 | T. Moyo | Medical Technologist | REF-26-001 | TM | 2026-10-01 | S. Dlamini | Within limits | ||
| 2 | R. Naidoo | Senior Technologist | REF-26-002 | RN | 2026-10-08 | A. Mensah | |||
| 3 | S. Dlamini | Quality Officer | REF-26-003 | SD | 2026-10-15 | L. Banda | |||
| 4 | A. Mensah | Lab Assistant | REF-26-004 | AM | 2026-10-22 | K. Otieno | Within limits | ||
| 5 | L. Banda | Medical Technologist | REF-26-005 | LB | 2026-10-29 | T. Moyo | |||
| 6 | K. Otieno | Senior Technologist | REF-26-006 | KO | 2026-11-05 | R. Naidoo | |||
| 7 | T. Moyo | Quality Officer | REF-26-007 | TM | 2026-11-12 | S. Dlamini | Within limits | ||
| 8 | R. Naidoo | Lab Assistant | REF-26-008 | RN | 2026-11-19 | A. Mensah |
Sign-off
| Role | Name | Signature | Date |
|---|---|---|---|
| Completed by | |||
| Reviewed by |
Shaded cells are calculated automatically. Values in red are outside their limits. † marks a corrected value (see Corrections).
Controlled document. Printed copies are uncontrolled unless stamped.Page 1
A4 landscape · first page · showing 8 of 8 rowsExactly as LabToolkit Pro prints it — with your logo and colours
What it records
- Full Name
- Designation
- Employee No.
- Authorized From
- SPECIMEN OF SIGNATURE
- Specimen of Initials
- Date Verified
- Verified by
- Comments
Sign-off
- Completed by
- Reviewed by
Related templates
- Personnel File Checklist (PR12-F01)
- Personnel Orientation Checklist (PR12-F02)
- Code of Ethics, Impartiality & Confidentiality Declaration (PR12-F03)
- Personnel Training & Continuous Professional Development Plan (PR12-F04)
- Training Evaluation Form (PR12-F05)
- Competence Matrix (PR12-F06)
- General Competence Assessment Form (PR12-F07a)
- Management System Training and Competence Form (PR12-F07b)
- Departmental Technical Training and Competency Assessment (template for F07c–F07i) (PR12-F07c)
- Competency Assessment Form (PR12-F08)
- Personnel Authorization Matrix (PR12-F09)
- Work Schedule (PR12-F11a)
- Departmental Duty Roster (PR12-F11b)
- On-call Roster (PR12-F11c)
- Personnel Replacement Form (PR12-F12)
- Guide: ISO 15189 documentation checklist
Clause references are to ISO 15189:2022; check them against your licensed copy of the standard.