AED Inspection Teammate Completing Inspection:* Business / Organization:*On Site Contact:*Phone:*Email:*A copy of this report will be emailed to the contact.Address of AED Location* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Location of AED at Address:*AED Brand:*SelectCardiac ScienceDefibtechHeartSinePhilipsPhysio-ControlZollOtherOther AED Brand:*Be as specific/descriptive as possible. Powerheart AED G3 Plus Powerheart AED G3 Pro(Has ECG Screen) Powerheart AED G5 Defibtech Lifeline Defibtech View(Has ECG Screen) Heartsine Samaritan 350P & 450P Heartstart OnSite AED Heartstart FRX HeartStart FR3 Lifepak Express AED Lifepak CR Plus Lifepak 1000 Zoll AED Plus Zoll AED Pro Does AED have 3-Dimensional Signage?*A 3D sign is a triangular marker on the wall above the AED so that its location can be seen from either direction.YesNoIs AED accessible at all time that the building is occupied?*If kept in a locked office, select "No"YesNoIs AED kept in a wall mounted cabinet?*Yes, cabinet is alarmedYes, cabinet is not alarmedNo, but AED is attached to a wallNoDoes AED have a carrying case?*YesNoDoes AED have a rescue kit?*If not attached to AED, please attach it if possible and indicate that it is attached to the AED.Yes, and rescue kit is attached to AEDYes, but it is not attached to AEDNo rescue kitDoes rescue kit include each of the following items?*-Gloves -Gauze or Towel -CPR Pocket Mask or Barrier -Razor -Scissors or shearsYes, rescue kit is fully stockedNo, rescue kit is missing itemsWhat is missing from rescue kit?*Adult Pads Expiration Date:*
