Defibrillator Update

DEFIBRILLATOR INFORMATION
If you have any questions please email, or for any urgent queries call us on 0800 ST JOHN (0800 785646)
If you are not responsible for the maintenance and upkeep of a defibrillator device, please forward this form link to the appropriate person.
If you have another contact person for your defibrillator please complete the secondary contact persons details section.
If you have more than two defibrillators or defibrillators at different locations you can download and complete this excel form and send it back to us

Contact persons details

First Name*

Last Name*

Email Address*

Company

Phone Number*

Secondary contact persons details

First Name

Last Name

Email Address

Phone Number

Defibrillator Information

Defibrillator Serial Number*

Defibrillator Pad Expiry*

Defibrillator Battery Expiry*

Defibrillator Model Name (if known)

Defibrillator Location/Branch*

Yes, I would you like to register this defibrillator with 111 emergency service (Please read the following information here first.)

Physical location of Defibrillator and Information
If you have more than two defibrillators or defibrillators at different locations you can download and complete this excel form and send it back to us
When selecting a location for your defibrillator, please carefully consider the accessibility for the general public to easily locate it. Provide detailed information regarding access, including door codes, entry/exit instructions, and any other relevant details.

Business Name*

Street Address*

Where within the location is the defibrillator located? (be as specific as possible)*

Hours defibrillator is available*

Cabinet code

Your privacy is important to us. Hato Hone St John collects your details to keep you informed about our work. If you need to contact us, call us on 0800 ST JOHN (0800 785 646) 7am – 5pm Monday to Friday, and 7.30am – 12.30pm.
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