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Run: 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,...

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Check Details

Defibrillator / AED ID (required)

Enter the asset tag, room number, or other unique device identifier.

Month of Check (required)

Select the month being documented. Use the first day of the month if your process requires a date value.

Location (required)

Enter the device location (for example, building name and floor).

Checked By (required)

Enter the name or role of the person completing the check.

Functional Status

Self-Test Result (required)

Record the latest device self-test or readiness indicator result.

Readiness Indicator Status (required)

Select the current status shown on the device, if applicable.

Audible Alarm or Warning Present? (required)

Indicate whether any alarm, warning light, or error message is present.

Functional Issue Notes

Describe any error codes, alarms, or other issues observed.

Pads and Battery

Pad Condition (required)

Confirm the electrode pads are present, sealed, and within expiration date.

Pad Expiration Date

Enter the expiration date if visible on the package or device record.

Battery Status (required)

Record the battery condition shown by the device or inspection.

Battery Expiration Date

Enter the battery expiration date if applicable.

Corrective Actions and Sign-Off

Corrective Action Required? (required)

Select Yes if any item failed or needs follow-up.

Corrective Action Details

Describe the issue, interim controls, replacement parts needed, and who was notified.

Escalated To

Enter the supervisor, maintenance contact, or vendor notified.

Check Complete (required)

Confirm that the monthly functional check has been completed and recorded.

Yes No N/A

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