periodic

AED Periodic Inspection Form

This process is very quick. The method outlined herein is intended to give your company a historical profile on each AED device. Keep in mind, that you will be able to retain information on your AED by control number. If you do not have a control number, ask your vendor for one. It is a unique alpha-numeric identifier like a social security number. This gives the owner of the AED control of information, even events that take place over time. You can request your own unique login for your company and join the data you enter here directly into your database or Microsoft Excel.

Your Name:

Phone Number

(999)999-9999

Email

Use the Account number if you have more than one AED to report on. Or, the serial number if you have one (1) AED for this form. You can also fill out separate forms using one form for each AED.

Account or Customer ID Number:

Account number is given to you by your vendor that has supplied you with your AED maintenance program. If you have a control number then it would be provided by your AED vendor or your onsite Responder.

Serial Number or assigned Control Number:

Comments:

Indicate here in COMMENTS, what is wrong or needs attention.

Type of Work Order

PM = Periodic Inspecton (general); PQ = Quarterly; P2 = Every 2 years; P4 = Every 4 years; CM = Corrective Maintenance; DM = Demand Work; and EV = Emergency Work Orders.

Check options: (check all that apply)

Battery OK Pads OK Ready Rescue Indicater On Alarm OK Cabinet OK Our site AED's are all working per manufactures specifications Please contact me. I have one or more AED's that have problems