Ambulance Equipment Checklist Form
Complete this checklist to verify ambulance equipment readiness before or after service.
Vehicle Identification Number or License Plate
*
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Checklist Status
*
Before Service
After Service
Oxygen Supply Present and Functional
*
Yes
No
Not Applicable
Defibrillator Checked and Operational
*
Yes
No
Not Applicable
First Aid Kit Stocked
*
Yes
No
Not Applicable
Stretcher Available and Functional
*
Yes
No
Not Applicable
Suction Unit Checked
*
Yes
No
Not Applicable
Personal Protective Equipment (PPE) Available
*
Yes
No
Not Applicable
Additional Notes
Submit Checklist
Should be Empty: