AED Monthly Check

• AED Monthly Inspection

• Conducted on

  Date

• Prepared by

• Location
  Address

• Is the AED unit located in its designated area?

  Yes

  No

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

  Yes

  No

• Is the AED rescue kit present and either stored on the carry case or cabinet of the AED unit?

  Yes

  No

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

  Yes

  No

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

  Yes

  No

• Does alarm on AED cabinet in working order? Note: Batteries should be replaced annually.

  Yes

  No

• Are the electrodes attached to the unit?

  Yes

  No

• Is the Status Indicator showing a green check mark?

  Yes

  No

• Are the batteries within the expiration date?

  Yes

  No

• Are you re-installing new electrodes or batteries?

  Yes

  No

• If re-installing new electrodes or batteries, did you turn unit on to allow it to complete a full self-test to confirm a visible green check mark?

  Yes

  No

Additional Photos

• Add media

  Media

Signature

• Inspector Signature

  Sign