SAN BERNARDINO COUNTY DEPARTMENTS - AED
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1
. What is the name of your department?
What is the name of your department?
2
. How many employees are in your department?
How many employees are in your department?
3
. Does your department have an automatic external defibrillator (AED)?
Does your department have an automatic external defibrillator (AED)?
Yes
No
4
. If you answered yes to question #3, what brand of AED? (If your department has multiple AEDs, please list all brands)
If you answered yes to question #3, what brand of AED? (If your department has multiple AEDs, please list all brands)
5
. How many employees are trained to use the AED?
How many employees are trained to use the AED?
6
. How many work sites does your department have?
How many work sites does your department have?
7
. If you answered "yes" to question #6, does your department have an AED at each work site?
If you answered "yes" to question #6, does your department have an AED at each work site?
Yes
No
8
. Who is the designated AED Medical Director?
Who is the designated AED Medical Director?
Name:
Company:
Address:
City/Town:
ZIP:
Country:
Email Address:
Phone Number:
9
. Please provide the name of the person and contact information for the person responsible for your AED program
Please provide the name of the person and contact information for the person responsible for your AED program
Name:
Department:
Address:
City/Town:
ZIP/Postal Code:
Mail Code:
Email Address:
Phone Number:
10
. Would you be interested in ICEMA providing medical oversight, free of charge, for your AED program?
Would you be interested in ICEMA providing medical oversight, free of charge, for your AED program?
Yes
No
11
. Comments
Comments
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