First Aid Oral Exam Form
Use this form to assess knowledge and responses during a first aid oral exam. All responses should be recorded clearly and accurately.
Examinee Full Name
*
First Name
Last Name
Examiner Name
*
Date of Exam
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
What is the first thing you should do when you arrive at the scene of an accident?
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Check for safety
Call emergency services
Move the injured person
Other
List the steps you would take to treat a minor burn.
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How would you respond to someone who is choking and cannot speak?
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Encourage them to cough
Perform abdominal thrusts (Heimlich maneuver)
Give them water
Other
Describe how to control severe bleeding until help arrives.
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Rate the examinee’s confidence in answering first aid questions.
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1
2
3
4
5
Did the examinee demonstrate clear communication and reasoning?
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Yes
No
Examiner Comments
Submit Exam
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