FW used similar forms.
I have found a couple of them in munich, for the FW190A3 & A5. They had three columns, first one with the demanded values and the other two where the values from the two check flights were to be inserted.
The flights required only tests at Climb & Combat power, but i guess that was to prevent overstrain on a fresh engine.
Interesting to note that the inspection pilots were also ordered to test the control forces and if they were inside the limits.