Defibrillator Survey Company Details Question Title * 1. Company Name OK Question Title * 2. Number of Staff OK Question Title * 3. Location Cheltenham Gloucestershire Other (please specify) OK Question Title * 4. Do you have a defibrillator on site? Yes No Comment (optional) OK Question Title * 5. If No, do you have any plans to install one? Yes No If Yes, please give brief details of your plans. OK Question Title * 6. Do you have a nominated First Aider on-site to deal with a sudden cardiac arrest or workplace health emergency? Yes No Comment (optional) OK Question Title * 7. Have any staff have had training in CPR within the last 2 years? Yes No Comment (optional) OK Question Title * 8. When was your defibrillator installed? Within the last year Within last 2 years 3 or more years ago Not sure Comment (please specify) OK Question Title * 9. Have you ever had to use your defibrillator? Yes No If yes, please give a brief description of the event OK Question Title * 10. Where is your defibrillator located? In a prominent place, clearly labelled and easily accessed by all employees On the building exterior with 24 hr & public access In a separate room usually used by specific staff e.g. Medical Room, Managers Office, In an cupboard/place that isn't specifically labelled as containing the defibrillator. Not sure Other (please specify) OK Question Title * 11. 7. Who looks after the servicing and upkeep of the defibrillator? We have a contract with the supplier We have a contract with our local Ambulance Service There are no special arrangements for maintenance Not sure Other (please specify) OK Question Title * 12. Please add any further comments here OK DONE