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DH WALKER OFFLOADING DEVICE Eligibility Checklist
Note: This form must be completed by the WCS and submitted for approval
along with the Formulary Medical Supply Order Form, via HP to
ESC SUPPLY (Limit
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How to fill out public access defibrillation provider

How to fill out public access defibrillation provider
01
Gather necessary information such as organization name, address, and contact details.
02
Identify the location and number of defibrillators available for public access.
03
Provide details on the maintenance schedule and procedures for the defibrillators.
04
Include information on who is responsible for overseeing the program and ensuring compliance with regulations.
05
Submit the completed form to the appropriate public health department for approval.
Who needs public access defibrillation provider?
01
Public places such as schools, shopping malls, airports, and sports facilities.
02
Workplaces with a high risk of sudden cardiac arrest incidents.
03
Community organizations hosting events with large crowds.
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What is public access defibrillation provider?
A public access defibrillation provider is an organization or entity that makes automated external defibrillators (AEDs) available to the public to help respond quickly to cardiac emergencies.
Who is required to file public access defibrillation provider?
Organizations that own or operate AEDs and wish to ensure compliance with local regulations are typically required to file as a public access defibrillation provider.
How to fill out public access defibrillation provider?
To fill out the public access defibrillation provider form, one must provide detailed information about the organization, the location of the AEDs, and ensure all contact and operational information is accurate.
What is the purpose of public access defibrillation provider?
The purpose of a public access defibrillation provider is to facilitate widespread access to AEDs in public spaces, thereby increasing the chances of survival for individuals experiencing sudden cardiac arrest.
What information must be reported on public access defibrillation provider?
Information that must be reported includes the number and location of AEDs, the responsible organization, contact information, and maintenance logs.
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