Title Page
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Conducted on
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Prepared by
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Location
Vehicle Inspection Report
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Vehicle Number
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Beginning Odometer Reading
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Insurance card and accident procedures information in the vehicle?
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Picture of front view of vehicle
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Picture of drivers side view of vehicle
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Picture of passengers side view of vehicle
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Picture of rear view of vehicle
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Any exterior damage noted (dents larger than a fist, missing or loose body parts, broken glass, etc.) Please provide details and photo evidence.
Vehicle Inspection Report
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Tire Tread notes to be acceptable? Do all tires appear to be properly inflated?
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Turn Signals, head lights and tail lights operational? (front a rear both sides of vehicle)?
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Interior and Exterior Mirrors Present and Properly Adjusted?
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Any squeaks or Unusual Noises Noted From Running Engine? Please provide details if answered Yes.
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Check engine or other warning lights noted while the vehicle is running? Please provide details if answered Yes.
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After a Short Drive Around a Parking Lot, Brakes and Steering Noted to be Operating Correctly?
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Seat Belts Operational?
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I hereby certify that I have completely inspected my vehicle according to the Trident USA Health Services daily vehicle inspection checklist. The interior of my vehicle is clean and free of trash and do hereby verify that if I feel that my vehicle is unsafe to operate, that I will report it to my supervisor immediately. I will report any accidents, no matter how slight they may seem, to my supervisor before the end of my shift.
