• Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Fatigue Score - USE FATIGUE SAFE APP OR PHONE SUPERVISOR for assistance

Mercedes Sprinter Pre-start checklist

  • Inspection Date/Time

  • Driver

  • Vehicle Registration

  • Odometer


  • Service interval within label specification

  • Water Level OK

  • Oil Level OK

  • No Apparent Leaks

  • Fuel >1/2 full

  • Turn signals operational

  • Brake lights operational

  • Head Lights

  • Driving Lights

  • Tail Lights

  • Load and side Lights

  • Reverse Quacker

  • Flashing Lights

  • Interior Lights

  • Wheelchair lift and step operates

  • Reversing Cameras

  • Vehicle body in good condition

  • Tyres in good condition

  • Vehicle clean and beds made

Administration items

  • Tablet charged and working

  • Mobile Phone charged and working

  • Patient Care Record Folder stocked per list

  • Authorised Driver credentials present

  • Forms Folder on board

  • Fuel Card

Other Safety Items

  • Fire extinguisher charged and inspected

  • Safety vests

  • Torch

  • Umbrella present and secure

  • Cleaning items adequate

Medical Equipment

  • Stretchers Servicable

  • Linen Pack

  • Wheelchair functional and secure

  • Oxygen Cylinders >25%

  • Defibrilator checked

  • Primary response Kit

  • Airway Kit

  • Inverter Operational

  • PPE adequate

List any other action items that need to be corrected

  • Enter/list issues here.


  • Driver

  • Crew

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.