Name of defibrillator guardian (person responsible for defibrillator checks and maintenance)* Email* Alternative guardian name Alternative email Phone Organisation name* Address*Number of defibrillators at this location* Defibrillator location(s) eg on the wall at 24/7 reception, in cabinet outside the main entrance* Defibrillator accessible 24/7?* Yes No UK standard defibrillator sign* I confirm I have the UK standard defibrillator sign displayed with my defibrillator(s) (Available to download)Defibrillator(s) is/are registered with NWAS* I confirm my defibrillator(s) is/are registered with NWAS (If they are not already, please register here before you proceed)Please note that all defibrillators registered with North West Ambulance Service will be added to a list of available equipment that could be used to help save someone’s life in the event of a nearby emergency. The ambulance service will instruct the 999 caller to get the equipment and take it from your premises to help the patient. It will be returned to you after the event and we will replace consumables.Please provide details of the training provided to those at the location to give them the confidence to do CPR and use the defibrillator (refresher training must be delivered at least once a year)*How do you promote the chain of survival – the actions that people should take increase the chance of survival for a victim of cardiac arrest – including resuscitation skills and defibrillator awareness?*Consent* I have read, understood and agree to the terms outlined in the privacy policy.CAPTCHA
