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2. Purpose
4. This AED Registration Form is designed for citizens and businesses to provide essential information about their Automated External Defibrillator (AED) devices. By registering your AED, you will help emergency responders and 9-1-1 telecommunicators quickly locate and direct callers to the nearest AED during an emergency situation, potentially saving lives. The form collects detailed information about the AED, including its location, accessibility, and maintenance status. This information ensures that the AED can be efficiently and effectively used in a critical moment. Your participation in this registration process is invaluable to our community's safety and preparedness. Thank you for contributing to a safer environment for everyone.
6. AED Point of Contact
8. First and Last Name*
9. Email Address*
11. Phone Number*
12. New or Update*

    1. This is a NEW registration
    2. This is to UPDATE a previous registration
14. AED Information
16. AED Make and Model
17. AED Pad Expiration Date
19. Business Name (if applicable)
21. Address where AED is located:*
23. City*
24. State
25. Zip Code
27. Description of where AED is located on property (Example: On wall in lobby to the right of the front door)*
29. 1. I would like a FREE annual inspection of my AED.
    2. I would like someone to contact me about FREE AED training for myself and/or staff.
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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field