Ambulance Cot Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

Stryker Model 6082 or 6092 Ambulance Cot Inspection (Every 6 months )

• Cot Inspection

Cot

• Enter model of Cot to be inspected

  Model 6082

  Model 6092

• Serial number

• Truck Number

• All fasteners secure

• All welds intact,not cracked or broken

• No bent or broken tubing or sheet metal

• No debris in wheels

• All wheels secure, rolling and swiveling property

• Optional wheel lock holds wheel securely when on and clears wheel when off

• Side rails move and latch properly

• Backrest operating properly

• Optional accessories intact and operating property

• Height positioning latch functioning properly

• Cot secure in each height position

• Undercarriage folds properly

• Breakaway head section operating properly

• Safety bar operating properly

• Foot rest operating property

• No rips or cracks in mattress cover

• Body restrains intact and working properly

• Lubricate base tubes(Model 6082)

• Lubricate pivot points (Model 6092)

• Comments

• Date inspected

  Date

• Inspected by

  Sign