Vehicle Daily Inspection
Date
*
-
Month
-
Day
Year
Date
Time of check
*
Hour Minutes
AM
PM
AM/PM Option
Driver
*
First Name
Last Name
Attendant (if applicable)
First Name
Last Name
Call Sign
*
Registration Number (Number Plate)
*
Back
Next
Vehicle Exterior
*
Yes
No
N/A
Clean
Mirrors & Windscreen (inc. wipers)
Vehicle Lights
Emergency Lights & Siren
Tyres (condition, pressure, depth 2.5min)
Bodywork free of damage
All doors open from inside & out
Back
Next
Engine Compartment
*
Yes
No
N/A
Screen Wash Level
Coolant Level
Engine Oil Level
Brake Fluid Level
Power steering Fluid Level
Coolant Level
*
Oil Level (on dipstick)
*
Back
Next
Cab Area
*
Yes
No
N/A
Fuel Level Above 1/2
Brakes
Road Horn
Fire Extinguisher
Fuel Card
Radios
Sat Nav (Google Maps is ok)
Clean
Torch
Hi-Vis Vests for all crew
Back
Next
Saloon
*
Yes
No
N/A
Seat Belts
Interior Lighting
Dash Board Clean
Air Conditioning
Heating
Back
Next
Response Bag
*
Yes
No
N/A
Manual Suction Unit
Adult & Child BVM
OP Airways (Size 2,3,4,5)
NP Airways (Size 6,7,8 with lube)
iGel Airways (Size 3,4,5 with lube)
iGel Tree Kit
Adult & Child Non-Re Mask)
Nasal Canula
Adult & Child Nebuliser
Bleed Kit
Burns Kit
First Aid Kit
Ambulance Dressings
Back
Next
Observation Pouch
*
Yes
No
N/A
Pulse Oximeter
BP Cuff
Penlight
Stethoscope
Thermometer
BM Kit
Tuff Cuts
Back
Next
Medical Equipment
*
Yes
No
N/A
AED or Monitor (MRX/Lifepack)
Entonox Kit
CD Oxygen
Large Oxygen
EMT Drugs
Paramedic Drugs
Stretcher
Carry Chair
Suction Unit
KED
Helmets
Long Board
Scoop
Ramp
Back
Next
PPE/IPC
*
Yes
No
N/A
Gloves
Aprons
Hand Gel
Clinnel Wipes
Spill Kit
Face Masks
General Waste Bags
Clinical Waste Bags
Vomit Bowls, Urinals, Bed Pan
Blue Roll
Back
Next
Exterior of Vehicle
*
Rear of inside Vehicle (Ambulance Only)
Default or Damage
14/08/2025: Known damage to NW204 to rear doors, no need to report
Added by Liam Booth
Default or Damage Details
Mileage
*
I confirm I have completed this form accurately and correctly as possible.
Name
First Name
Last Name
Submit
Should be Empty: