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AED Registration Form

  1. City of Temple Terrace Fire Department logo

  2. Temple Terrace Fire Department AED Registration Form

  3. Fire Administration

    124 Bullard Pkwy., Temple Terrace, FL 33617 - Phone (813)605-6700, Fax (813) 506-6701

  4. AED Registration Program

    The City of Temple Terrace Fire Department identifies the importance of AED's and their use during a cardiac emergency. Completion of this form helps the Temple Terrace Fire Department know where these life-saving units are located. This allows our emergency response personnel to better serve its community by knowing what interventions have been completed prior to their arrival and ensuring the highest level of patient care.

  5. Contact information:

  6. AED information:

  7. Please be specific on installation locations (i.e., West wall of gym, patient waiting room, principal's office, etc.)

  8. Is AED in a monitored cabinet?*

  9. Has staff been trained in AED use?*

  10. Has staff been trained in CPR?*

  11. Leave This Blank:

  12. This field is not part of the form submission.