If you're intending for this form to be used universally on all equipment/production lines, you need to add a place for the operator to write in what line or equipment they are verifying. Your note about the ATP swab referring to an allergen ingredient is misleading, as you produce fish and fish is an allergen (so every single product change would require a clean and ATP swab per this instruction).
If I nitpick more, given my SQF background, I'd want to know what scale is being zeroed and weight checked (I number all my scales), and I'd want to document what test weight you're using (I've numbered test weights or just referred to them by their weight in plants that only had one of each weight). With the MD, same deal to document which one you're using, but are they just verifying it's clean or is this the proof they've challenged it with test pieces? MD checks should probably be on a separate form to allow the checks at your prescribed frequency.
Lastly, I like to give operators a few blank lines at the bottom of these pre-op or change over forms to document any random findings that aren't specific to the checklist. Totally a odd preference thing, but it's helped me in the past.