Village Unit Information

Village Details

Number of Units

Type of Unit:

Ceiling Access?

How Many Village Stages Are Built?

On site or Off site monitoring?

On Site/Off Site Details: (ie Smartwatch paging system, Tunstall monitoring)

Type of Medical Alarm System:(Make and Model)

Trigger Details

Dialer 1

Type of Device

Location:

Trigger 2

Type of Device

Location

Trigger 3

Type of Device

Location

Trigger 4

Type of Device

Location

Trigger 5

Type of Device

Location

Trigger 6

Type of Device

Location

Trigger 7

Type of Device

Location

Trigger 8

Type of Device

Location

Smoke Detectors

Smoke Detectors Installed?

Type of Device

Location

QTY:

Inputs and Outputs

Are there any Hard Wired Inputs

Number of inputs:

Type of Input

is there any Hard Wired Outputs

Type of Output
Power Supply Locations.

Please explain location of Power Supply

Phone Number Programing

Phone Number 1:

Phone Number 2:

Phone Line

Type of Phone Line

Is there mode 3?

Number of Phone Outputs

Community Centre Details

Number of Community centre:

Centre Details
Type of Building

On Site/Off Site Monitoring

On Site System/Off site Monitoring Details:

Type of Medical Device:

Device Details

Dialler 1

Location of Dialler:

Location of Power Supply

Trigger 1 Type

Location:

Trigger 3 Type

Location:

Trigger 2 Type

Location:

Trigger 4 Type

Location:

Trigger 5 Type

Location:

Trigger 6 Type

Location:

Trigger 7 Type

Location:

Dialler 2

Location of Dialler:

Location of Power Supply

Trigger 1 Type

Location:

Trigger 3 Type

Location:

Trigger 2 Type

Location:

Trigger 4 Type

Location:

Trigger 5 Type

Location:

Trigger 6 Type

Location:

Trigger 7 Type

Location:

Dialler 3

Location of Dialler:

Location of Power Supply

Trigger 1 Type

Location:

Trigger 3 Type

Location:

Trigger 2 Type

Location:

Trigger 4 Type

Location:

Trigger 5 Type

Location:

Trigger 6 Type

Location:

Trigger 7 Type

Location:

Dialler 4

Location of Dialler:

Location of Power Supply

Trigger 1 Type

Location:

Trigger 3 Type

Location:

Trigger 2 Type

Location:

Trigger 4 Type

Location:

Trigger 5 Type

Location:

Trigger 6 Type

Location:

Trigger 7 Type

Location:

Dialler 5

Location of Dialler:

Location of Power Supply

Trigger 1 Type

Location:

Trigger 3 Type

Location:

Trigger 2 Type

Location:

Trigger 4 Type

Location:

Trigger 5 Type

Location:

Trigger 6 Type

Location:

Trigger 7 Type

Location:

Dialler 6

Location of Dialler:

Location of Power Supply

Trigger 1 Type

Location:

Trigger 3 Type

Location:

Trigger 2 Type

Location:

Trigger 4 Type

Location:

Trigger 5 Type

Location:

Trigger 6 Type

Location:

Trigger 7 Type

Location:

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.