Julie Bacon

Critical Ambulance Checklist

To ensure NO major mechanical failures go unreported on any truck

Use this Template

Print as PDF

Use this Template

Title Page

Conducted on
Prepared by

Free of visible engine leaks potentially rendering the truck inoperable?
Does the engine start?
Free from warning indicators/alarms in the dash potentially rendering the truck inoperable?
Are the Medical Air and O2 both >1000 psi?
Is the black Ambulance Code Drug in the netted storage area?
Tires free of critical damage?
Is the Philips monitor present and charging?
Are the fuel card and direction book present?
If a Sunstar Unit, please check the following:
- Onboard O2 >1500
- SS Unit bag present and sealed
- 2 E-Cylinders medical air present and full
- ACH fuel card and receipt pouch
- N/A
Signature of preparer:

Julie Bacon

Critical Ambulance Checklist

To ensure NO major mechanical failures go unreported on any truck

Use this Template

Print as PDF

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.