AED Inspection Checklist
Choose AED for Inspection
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Please Select
MBE #1
MBE #2
MBE #3
MBW #4
MBS #5
MBS #6
MBS #7
Rapid Fill Option
AED's are checked quarterly and components have long expiration dates. The rapid fill option exists to make form fill more efficient.
All inspection conditions are met and AED is in good working condition. Clicking "Yes" certifies all safety conditions are met and that you are choosing "Yes" to all six inspection criteria.
Yes
1. Is the Active Status Indicator light on your AED flashing green?
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Yes
No
2. Does the AED appear to be undamaged and ready for use?
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Yes
No
3. Is the AED free of chirping and warning notifications?
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Yes
No
4. Are the AED pads within 2 months or more of their usable date?
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Yes
No
5. Are the AED pads plugged in and ready for use?
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Yes
No
6. Is the AED battery within 2 months or more of its expiration date?
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Yes
No
Inspection Comments/Alerts
I confirm that all non-compliant sections have been appropriately marked and that all concerns have been reported
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Yes
Date
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Month
-
Day
Year
Date
Name
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First Name
Last Name
Signature
*
Submit
Should be Empty: