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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 place. This log helps you catch readiness issues before t...

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Check Details

Month of Check (required)

Select the month the functional check was completed.

AED / Defibrillator ID (required)

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

Device Location (required)

Enter the current location of the device.

Functional Status

Self-Test Result (required)

Record the device self-test result shown on the unit or indicator.

Status Indicator (required)

Record the visible readiness indicator on the device.

Audible Alarm or Error Message Observed? (required)

Select Yes if the device displayed an alarm, warning, or error message.

Functional Issue Details

Describe the issue observed and any immediate actions taken.

Pads and Battery

Pads Present? (required)

Confirm that electrode pads are present with the device.

Pads Expiration Date

Record the expiration date if visible on the pad package.

Pads Condition (required)

Record the condition of the pads and packaging.

Battery Status (required)

Record the battery status shown by the device or indicator.

Corrective Actions and Sign-Off

Corrective Action Required? (required)

Select Yes if any issue needs maintenance, replacement, or escalation.

Corrective Action Details

Describe the action needed, such as pad replacement, battery replacement, or service request.

Checked By (required)

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

I confirm this monthly functional check was completed accurately. (required)

Confirmation statement for audit trail and accountability.

Yes No N/A

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