The School Board of Broward County, Florida

Automatic External Defibrillator (AED)
 Accessories Order Form

Please fill out the following information.  Once you click "Submit Order", your request will go directly to the SAFETY DEPARTMENT.  Your accessories should arrive to you within 10 days.  DO NOT DISCARD EXPIRED ACCESSORIES BEFORE YOU RECEIVE THE NEW ONES.

Also, please make sure you review the AED guidelines by clicking :
 AED GUIDELINES  and  AED District Information

Thank you!
Date:
Name of School:  
Location Number:
Requestor Name:  
Title:  
Phone:   () -
Email Address:
Accessories Needed:   Expiration Date AND Serial Number must be filled in.
AED Serial Number
Adult Replacement Pads Did you use the
AED?

Expiration Date:		  


 

Replacement Battery

Expiration Date:
PEDIATRIC PADS:  Please call Health Services at 754.321.2274 for prior
                                     approval for Pediatric Pads.

 Comments:      

 

If you have any further questions or concerns, please contact the Safety Department at 754.321.4200.
 
Copyright © 2007 by Safety Department, School Board of Broward County. All rights reserved.
Revised: V.Stanford, 17 May 2012 08:25:53 -0400 .
Copyright © 2001 by Safety Department, School Board of Broward County. All rights reserved.
Revised: V.Stanford, 17 May 2012 08:25:53 -0400 .