Title Page

  • Conducted on

  • Prepared by

  • Location
  • Is there anything blocking or obstructing the box?

  • Is the emergency break glass intact and/or present?

  • Is there any visual damage to the wall boxes?

  • Is the padlock on the box, and is it in good condition? and locked?

  • Is the emergency first aiders button beside the box?

  • Are the bottles of eyewash sealed and in date?

  • Is the defibrillator hanging on the wall with no obstructions?

  • Is there any visible damage to the defibrillator?

  • Is the defibrillator light flashing green to say the system is OK?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.