AED Monthly Check

• Document No.

• Conducted on

  Date

• Prepared by

• Location
  Address

• Is the AED unit located in its designated area?

  Yes

  No

  N/A

• Is the AED unit clean, undamaged, and in its carry case?

  Yes

  No

  N/A

• Is the AED rescue kit present and stored on the carry case attached to the AED unit?

  Yes

  No

  N/A

• Does the AED rescue kit include: gloves, prep razor, scissors, towel, moist towelettes, CPR mask?

  Yes

  No

  N/A

• Are all electrode packages sealed and within the expiration date?

  Yes

  No

  N/A

• Is the Status Indicator showing a green check mark or the word 'OK'?

  Yes

  No

  N/A

• Are the electrodes attached to the unit?

  Yes

  No

  N/A

• Are the batteries within the expiration date?

  Yes

  No

  N/A

Additional Photos

• Location of AED

  Media

• Cleanliness of AED

  Media

• Rescue Kit

  Media

Signature

• Add signature

  Sign