Title Page

  • Document No.

  • Vehicle Call Sign

  • Vehicle Registration

  • Conducted on

  • Conducted by

  • Location
  • Ambulance crew names

External checks

  • Date and time completed

  • Vehicle mileage

  • Oil level within parameters

  • Water level within parameters

  • Screen wash filled

  • Windscreen wipers checked

  • Headlights working

  • Indicators working

  • Blue lights working

  • Tyre pressure and tread visual check

Internal checks

  • Response bag visual check present

  • Photo of response bag

  • Zoll visual check

  • Self test printout photo

  • LSU visual check

  • LSU and consumables photo

  • AED visual check

  • AED self test passed photo

  • Drugs back check

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