Run Defibrillator Monthly Functional Check Log — Free

Inspection Details

Device ID / Asset Tag

Enter the AED or defibrillator identifier used by your site.

Location

Record the exact mounted location or room where the device is stored.

Inspection date critical (required)

Date and time the monthly functional check was completed.

Inspector name critical (required)

Name of the person completing the inspection.

Device Self-Test and Status

Self-test indicator shows normal/ready status critical (required)

Verify the AED status indicator shows a normal or ready condition with no fault alert.

Yes No N/A

Audible or visual alarms present critical (required)

Confirm there are no active alarms, warning tones, or fault signals.

Yes No N/A

Device exterior clean and free of damage

Inspect the housing, screen, buttons, and carry case for cracks, missing parts, contamination, or other damage.

Yes No N/A

Accessory compartment secure and complete

Confirm the device case or cabinet contains all required accessories and the compartment closes properly.

Yes No N/A

Pads and Electrode Readiness

Pads present and unopened critical (required)

Verify electrode pads are present, sealed, and not previously opened or used.

Yes No N/A

Pads within expiration date critical (required)

Check the pad package expiration date and confirm it has not passed.

Yes No N/A

Pads package condition acceptable critical (required)

Confirm the pad package is intact, dry, and free from tears, punctures, or seal failure.

Yes No N/A

Correct pad type for device model

Verify the pads are compatible with the AED model and intended patient use.

Yes No N/A

Battery and Power Readiness

Battery installed and secure critical (required)

Confirm the battery is installed correctly and the compartment is closed and secure.

Yes No N/A

Battery status indicates sufficient charge critical (required)

Verify the battery indicator or device display shows adequate charge or readiness.

Yes No N/A

Battery replacement date checked

Record the battery expiration or replacement date if shown on the device or battery label.

Spare battery available if required by site SOP

If your site procedure requires a spare battery, confirm one is available and in date.

Yes No N/A

Accessibility, Signage, and Corrective Action

AED location accessible and unobstructed critical (required)

Confirm the defibrillator cabinet, wall mount, or storage location is accessible without obstruction.

Yes No N/A

Cabinet or storage signage visible

Verify AED signage is visible and the device can be quickly identified in an emergency.

Yes No N/A

Any deficiency identified during inspection

Mark Yes if any issue, non-conformance, or missing item was found during this inspection.

Yes No N/A

Corrective action / service request details

Document the deficiency, immediate action taken, and who was notified for repair or replacement.

Inspector Sign-off

Inspector signature critical (required)

Signature confirming the monthly functional check was completed.

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Run: Defibrillator Monthly Functional Check Log

Inspection Details

Device Self-Test and Status

Pads and Electrode Readiness

Battery and Power Readiness

Accessibility, Signage, and Corrective Action

Inspector Sign-off

Get your results