Ambulance Checklist Form
Vehicle Information
Ambulance ID/Number:
Make and Model
Mileage
License Plate
Emergency Equipment Check
Defibrillator
Oxygen Tanks
First Aid Kit
Spinal Immobilization Devices
Suction Unit
Communication Systems
Radio Communication
Mobile Phone
GPS Navigation System
Medical Supplies Inventory
Medications and Drugs
Bandages and Dressings
Splints and Braces
Disposable Gloves
Vehicle Interior Inspection
Cleanliness
Adequate Lighting
Securely Stored Equipment
Engine and Mechanical Check
Fluid Levels (oil, coolant, brake fluid)
Tire Pressure
Battery Status
Lights and Sirens
Documentation
Driver's License and Certification
Vehicle Registration and Insurance
Patient Care Protocols
Personal Protective Equipment (PPE)
Reflective Vests
Helmets
Respirators/Masks
Vehicle Exterior Inspection
Body Condition
Lights (headlights, brake lights)
Mirrors
Tires and Wheels
Specialized Equipment Check
Stretcher
Hydraulic Lift
Ramp or Lift System
Crew Communication and Coordination
Crew Sign-In
Communication Protocols
Emergency Response Procedures
Any issues encountered during the inspection
Recommendations for maintenance or improvement
Date and Time of Inspection
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Signature
Submit
Should be Empty: