Defibrillator Monthly Functional Check Log
Track each AED’s monthly self-test, pad condition, battery status, and any corrective action in one clear log. Use it to prove the device was checked, ready, and escalated when needed.
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Overview
This Defibrillator Monthly Functional Check Log template is a workplace form for documenting whether an AED or defibrillator is ready for use. It captures the device ID, check month, location, and the person who performed the inspection, then walks through the key readiness indicators: self-test result, readiness indicator, audible alarm, pad condition, battery status, and expiration dates.
Use this template when you need a repeatable monthly record for emergency equipment that must stay available and functional. It is especially useful for offices, schools, warehouses, clinics, hotels, and other sites where staff need a fast way to confirm the unit is operational and to escalate any issue before the device is needed. The corrective action section helps you document what was found, what needs to happen next, and who it was escalated to.
Do not use this as a generic asset inventory form or a post-incident report. It is not meant for clinical event documentation, detailed maintenance service records, or one-time installation checklists. If your organization needs more than monthly readiness tracking, you can extend the template with conditional logic for post-use inspection, service vendor follow-up, or site-specific sign-off steps. The value of the form is in keeping the monthly check short, consistent, and easy to complete without skipping the fields that matter.
Standards & compliance context
- This template supports an audit trail for workplace emergency equipment checks by recording who performed the inspection, when it was done, and what was found.
- If your organization has a safety policy, manufacturer maintenance schedule, or local emergency preparedness requirement, align the monthly cadence and escalation steps to that standard.
- Keep the form focused on minimum necessary operational data and avoid collecting unrelated PII or medical details.
- If the log is used in a public-facing or shared workplace workflow, make the fields accessible and readable in line with WCAG 2.1 AA expectations.
General regulatory context for orientation only — verify current requirements with counsel or the relevant agency before relying on this template for compliance.
What's inside this template
Check Details
This section identifies exactly which AED was checked, where it is located, and who performed the monthly inspection.
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Defibrillator / AED ID
Enter the asset tag, room number, or other unique device identifier.
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Month of Check
Select the month being documented. Use the first day of the month if your process requires a date value.
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Location
Enter the device location (for example, building name and floor).
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Checked By
Enter the name or role of the person completing the check.
Functional Status
This section records whether the device passed its self-test and whether any audible or visual warning signs suggest a problem.
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Self-Test Result
Record the latest device self-test or readiness indicator result.
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Readiness Indicator Status
Select the current status shown on the device, if applicable.
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Audible Alarm or Warning Present?
Indicate whether any alarm, warning light, or error message is present.
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Functional Issue Notes
Describe any error codes, alarms, or other issues observed.
Pads and Battery
This section confirms the consumables that determine whether the AED can actually be used in an emergency.
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Pad Condition
Confirm the electrode pads are present, sealed, and within expiration date.
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Pad Expiration Date
Enter the expiration date if visible on the package or device record.
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Battery Status
Record the battery condition shown by the device or inspection.
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Battery Expiration Date
Enter the battery expiration date if applicable.
Corrective Actions and Sign-Off
This section captures the follow-up path for any issue and closes the loop with a final completion record.
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Corrective Action Required?
Select Yes if any item failed or needs follow-up.
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Corrective Action Details
Describe the issue, interim controls, replacement parts needed, and who was notified.
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Escalated To
Enter the supervisor, maintenance contact, or vendor notified.
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Check Complete
Confirm that the monthly functional check has been completed and recorded.
How to use this template
- Create one form entry per AED and prefill the device_id, check_location, and check_month fields so the inspector is documenting a specific unit for a specific month.
- Assign the check to the person responsible for the site or device and require them to complete the checked_by field before submission.
- Have the inspector record the self-test result, readiness indicator, audible alarm status, and any functional issue notes using the exact field values your policy defines.
- Record the pad condition, pads_expiration_date, battery_status, and battery_expiration_date so upcoming replacements are visible before the device is needed.
- If anything is not ready, mark corrective_action_required, describe the fix in corrective_action_details, escalate to the right owner, and only then mark check_complete.
Best practices
- Use a dropdown or fixed list for self-test result and readiness indicator so inspectors do not enter inconsistent wording.
- Make device_id and check_month required, and keep the rest of the fields optional only when they truly do not apply.
- Use date pickers for pads_expiration_date and battery_expiration_date so expiration data is accurate and easy to review.
- Add conditional logic that reveals corrective_action_details and escalated_to only when corrective_action_required is selected.
- Document the exact issue in functional_issue_notes instead of writing vague phrases like 'needs review' or 'checked okay.'
- Require a clear what-happens-next step when the AED is not ready, including who was notified and when.
- Keep the form short enough to complete during a walk-through so monthly checks do not get skipped.
- Review repeated failures by device_id or location to spot patterns such as recurring battery degradation or missing pads.
What this template typically catches
Issues teams running this template most often surface in practice:
Common use cases
Frequently asked questions
What does this defibrillator monthly functional check log cover?
This template covers the core monthly readiness checks for one AED or defibrillator: device identification, check month, location, who performed the check, self-test result, readiness indicator, audible alarm, pad condition, battery status, expiration dates, and any corrective action. It also includes a sign-off field so you can confirm the check is complete. Use it as a record of routine inspection, not as a replacement for manufacturer service instructions.
How often should this log be completed?
This template is designed for a monthly cadence, which is the most common interval for AED readiness checks. Some organizations may also add weekly visual checks or post-use checks after an emergency, but those are separate from this monthly log. If your manufacturer, insurer, or local policy requires a different schedule, adjust the check_month field and workflow accordingly.
Who should fill out the monthly AED check?
The log is typically completed by a trained site coordinator, safety lead, facilities staff member, or other assigned responder. The checked_by field makes ownership clear and supports an audit trail. If your workplace has multiple locations, assign one accountable person per device so checks do not get missed.
Does this template help with compliance or audit readiness?
Yes, it creates a simple record that the AED was inspected, the readiness indicators were reviewed, and issues were escalated. That supports internal safety programs and can help during audits, incident reviews, or insurance inquiries. It should be used alongside your organization’s emergency response policy and any manufacturer maintenance requirements.
What are the most common mistakes when using this log?
The most common issues are leaving the device_id vague, skipping expiration dates, marking the check complete without confirming the readiness indicator, and failing to document corrective actions. Another frequent mistake is writing free-text notes where a clear field choice would be better, which makes review harder later. Keep entries specific and complete so the log is useful after the fact.
Can I customize this for different AED brands or locations?
Yes, this template is meant to be customized. You can add brand-specific fields, location codes, asset tags, or conditional logic for devices with different battery or pad configurations. If you manage multiple sites, consider a location dropdown and a device inventory link so each log entry maps cleanly to one unit.
Should this be integrated with maintenance or incident workflows?
If possible, yes. A corrective_action_required response can trigger a maintenance ticket, notify facilities, or escalate to a safety manager. That reduces the risk of a failed AED check sitting in a spreadsheet without follow-up. The template works well as a front-end form that feeds a work order or audit trail.
How is this different from an ad-hoc checklist or spreadsheet note?
An ad-hoc note often misses key fields, uses inconsistent wording, and makes it hard to prove who checked what and when. This template standardizes the monthly inspection so every AED is reviewed the same way, with clear validation, sign-off, and escalation fields. That makes it easier to spot patterns like recurring battery issues or repeated pad expiration problems.
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