EMS Readiness Checklist Form
Complete this EMS Readiness Checklist Form to verify operational status, equipment, and team preparedness. Ensure all sections are reviewed for effective readiness assessment.
Date of Readiness Check
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Shift or Team Name
*
Vehicle Status
*
Operational
Requires Maintenance
Out of Service
Essential Equipment Checked
*
Defibrillator
Oxygen Supply
Stretcher
Suction Unit
First Aid Kit
Other
Medical Supplies Inventory Level
*
Fully Stocked
Partially Stocked
Needs Restocking
Communication Devices Functioning
*
All Operational
Some Issues
Not Operational
PPE (Personal Protective Equipment) Availability
*
Gloves
Masks
Gowns
Eye Protection
Other
Readiness Assessment
*
1
2
3
4
5
Team Members Present
*
Follow-up Actions or Notes
Submit Checklist
Should be Empty: