Title Page

  • Vehicle Check Conducted On?

  • Location Of Check

Vehicle Information

  • Vehicle Callsign

  • Vehicle Registration

  • Vehicle Model

  • Vehicle Make

  • Odometer / Milage Reading

Crew Information

  • Crew Member Name 1

  • Crew Member Name 2

  • Shift Type

  • Shift Start Time?

Vehicle Inspection

  • Do you wish to check the exterior of this vehicle in this inspection?

External Check

  • Windscreen free from damage?

  • Front Lights free from damage?

  • Front Bumpers and bodywork / paintwork in good condition?

  • Drivers Side - Tyres both front and rear in good condition and roadworthy with acceptable pressure and tread?

  • Drivers Side bodywork / paintwork in good condition from front to rear?

  • Rear Lights are free from damage?

  • Rear Doors, Bumpers bodywork/paintwork in good condition?

  • Passenger Side - Tyres both front and rear in good condition and roadworthy with acceptable pressure and tread?

  • Passenger Side bodywork / paintwork in good condition from front to rear?

  • Is the exterior of the vehicle clean?

  • Do you wish to check the interior of this vehicle in this inspection?

Internal Check

  • Is inside the vehicle in a clean and tidy condition?

  • Is there a First Aid Kit on board?

  • Is there a Fire Extinguisher on board?

  • Are all seat belts in good working order?

  • Are any warning lights illuminated on dash?

  • Are all vehicle front lights working?

  • Are all vehicle indicators working?

  • Are all vehicle stop/brake lights working?

  • Do you wish to check the emergency warning system of this vehicle in this inspection?

  • Do Grille and Dash Lights work?

  • Does Headlight Flash work?

  • Do Fend offs work?

  • Does the front lightbar work?

  • Does the rear lightbar work?

  • Do the rear blues work?

  • Do the rear reds work?

  • Do the scene lights work?

  • Do the alley lights work?

Maintenance Check

  • Do you wish to conduct a maintenance check of this vehicle in this inspection?

  • Are windshield washers in working order, with water filled?

  • Are engine oil levels within acceptable ranges?

  • Are coolant levels within acceptable ranges?

  • Are brake fluid levels within acceptable ranges?

  • What is the vehicle fuel level?

  • Are transmission fluid levels within acceptable ranges?

  • Is battery working and the vehicle starts?

  • Does the car horn function correctly?

  • Are all doors and door locks operational?

  • Is the air conditioning operational?

  • Is the vehicle free of grease leaks?

  • Is the vehicle free of fuel leaks?

  • Are the emergency and/or hand brakes operational and in good condition?

  • Are the vehicle power brakes operational and in good condition?

Equipment Check

  • Do you have a primary response bag?

  • Do you have a secondary response bag?

  • Do you have an oxygen bag?

  • Do you have an Entonox bag?

  • Do you a suction unit on board?

  • Is your battery charged?

  • Do you have a Zoll E Monitor on board?

  • Is the battery charged?

  • Do you have a drugs bag on board?

  • What levels of drugs are you carrying

  • Do you have a collar bag?

  • Do you have a scoop with straps?

  • Do you have a carry chair?

  • Do you have a wheelchair?

  • Do you have a stretcher bed?

  • Do you have piped oxygen?

  • Do you have helmets?

  • Do you have a satnav/ MDT?

  • Do you have radios?

Documentation Check

  • Do you wish to review vehicle documentation in this inspection?

  • Is Accident Report Form present in vehicle?

  • Is Event Blue Folder present in this vehicle?

  • Defect and Damage Log
  • Please log all damages and defects noted on the vehicle

  • Is there any damage of defects with the vehicle?

  • Select the location of this individual defect

  • What type of defect is the individual defect

  • Briefly describe this defect

  • Attach photos of defect (If Applicable)

General Comments

  • Any further comments or recommendations arising from this inspection?

  • Add any additional relevant photos

  • Have all required corrective actions been added as Actions to this inspection?

  • Please add any corrective actions to the appropriate questions above before completing this report

Sign Off

  • I, the undersigned, hereby certify that all information is accurate and that an actual inspection was conducted.

  • Staff Member Name and Signature

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