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AED INFORMATION FORM

If you would like your AED to be included on the HPCP app, please kindly complete the details below and return by clicking on the ‘send’ button.

Please also note that by submitting this form, you agree to do monthly checks of your AED, which will then be updated on the app’s database.

If you have any queries, please contact Michella on: 07977 222271    michella@freedom-pa.com

1.- Name of Organisation/School/Community Group

2.- Name of Person responsible for AED

3.- Contact number for responsible person

4.- Contact email

5.- Make and Model of AED

6.- Full address of AED site including post code

7.- Exact site of AED within the location

8.- Is the AED visible (including signage) and clearly accessible?

9.- Is the AED in a cabinet (or similar)?

10.- Is the cabinet locked?
YesNo

11.- If the cabinet is locked, is there a code to open? If locked the code must be provided on the cabinet

12.- Opening hours of site

13.- Will there always be a trained member of staff/public on site?

14.- Does the AED have the following items
ScissorsRazorSpare AED padsSwab (or similar)

15.- Does the site offer yearly AED training to staff/public?

16.- Is there a procedure/emergency plan in place for your AED?

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