BSH AED Monthly Check

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Is the AED unit located in its designated area?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Is the AED rescue kit present and either stored in AED cabinet?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Does alarm on AED cabinet in working order?

  Yes

  No

  N/A

• Is the Status Indicator showing a green check mark?

  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

• Are you re-installing new electrodes or batteries?

  Yes

  No

  N/A

• 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

  N/A

Additional Photos

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  Media

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  Media

Signature

• Add signature

  Sign