I have seen hundreds of these (completed) checklists over the years, and to be honest, the vast majority of them have been a waste of time. They usually don't answer the question, and they usually don't allow me to find the supporting documentation, or at least not all of it, easily.
So while there is nothing wrong with the template, do make sure you use it properly.
What I tend to recommend, if you want to go the extra mile, is to turn the whole thing 90 degrees, so that there is proper space for a detailed response to each ER.
a) justification of non-applicability
b) confirmation of which general harmonised standards are applicable, and if not met in full, justifications for non-applicability of the sections or the whole standard (EN13485, EN14971, EN10993-1, EN980, EN1041 etc)
c) confirmation of which product-specific harmonised standards are applicable, and if not met in full, justifications for non-applicability of the sections or the whole standard
d) Short description (text) of how all the elements of the individual ER have been addressed met, if not already covered above
e) Location of supporting documentation held within the Technical File
f) Location of supporting documentation not held within the Technical File