Run Defibrillator Monthly Functional Check Log — Free

Inspection Details

Inspection date and time critical (required)

Device identifier / asset tag critical (required)

Inspection location critical (required)

Inspector name and signature critical (required)

AED Self-Test and Readiness

Device self-test passed critical (required)

Confirm the AED internal self-test indicates normal operation with no fault or service alert.

Yes No N/A

Readiness indicator shows ready status critical (required)

Verify the status indicator is green/ready or otherwise indicates the unit is deployment-ready.

Yes No N/A

No error codes, alarms, or service lights present critical (required)

Check for any audible alarms, flashing lights, or displayed error codes requiring service.

Yes No N/A

Cabinet or storage case accessible and unobstructed critical (required)

Confirm the AED is mounted or stored in a location that is clearly accessible and not blocked.

Yes No N/A

Pads, Battery, and Consumables

Electrode pads present and sealed critical (required)

Verify adult pads are present, unopened, and stored according to manufacturer instructions.

Yes No N/A

Electrode pads expiration date valid critical (required)

Record the pad expiration date and confirm it has not passed.

Battery installed and within service life critical (required)

Confirm the battery is installed, secure, and not due for replacement based on the manufacturer service life or indicator.

Yes No N/A

Battery status indicates sufficient charge critical (required)

Verify the battery indicator shows adequate charge for immediate use.

Yes No N/A

Accessory kit present and complete

Check for required accessories such as scissors, gloves, razor, towel, or barrier device if applicable to the site SOP.

Yes No N/A

Physical Condition and Documentation

Device housing free of visible damage critical (required)

Inspect the AED casing, screen, connectors, and cables for cracks, corrosion, missing parts, or other visible damage.

Yes No N/A

Pads and battery replacement dates recorded

Confirm replacement or expiration dates are documented for tracking and preventive maintenance.

Yes No N/A

Inspection log completed and filed

Verify this monthly check is documented and retained per site procedure.

Yes No N/A

Corrective action documented for any deficiency

Describe any non-conformance, removed-from-service condition, or follow-up action taken.

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Run: Defibrillator Monthly Functional Check Log

Inspection Details

AED Self-Test and Readiness

Pads, Battery, and Consumables

Physical Condition and Documentation

Get your results