About this template
An ambulance rig check form is an essential daily tool used by emergency medical services (EMS) personnel to ensure that vehicles and life-saving equipment are fully operational before beginning a shift. Thorough inspections minimize response delays and guarantee compliance with medical safety standards.
This comprehensive Google Form template streamlines pre-shift audits by capturing critical vehicle metrics, oxygen tank pressures, fuel levels, and expiration dates for pharmaceuticals, AED pads, and trauma supplies. Crew members can quickly log inspections on mobile devices or tablets, providing fleet managers with instant documentation and real-time oversight of vehicle readiness.
Built for speed and accuracy in high-stakes environments, this template helps EMS stations eliminate paper checklists, maintain accountability across shifts, and ensure every ambulance is properly equipped for the next emergency call.
Key features
- Standardize pre-shift vehicle and equipment inspections across all crews
- Track vital metrics like fuel levels and oxygen tank PSI in real time
- Monitor expiration dates for critical medications, dressings, and AED pads
- Document vehicle cleanliness, shoreline charging, and maintenance issues instantly
- Access inspection logs from any mobile device or tablet at the station
Use cases
Daily pre-shift vehicle and equipment readiness checks for EMS crews
Post-maintenance verification before returning an ambulance to active…
Post-maintenance verification before returning an ambulance to active service
Periodic supply audits and medication expiration tracking for station…
Periodic supply audits and medication expiration tracking for station supervisors
What this form collects
- Crew Member Full Name(s) (Short answer)Enter the names of the crew members conducting this inspection.
- Ambulance Unit Number (Short answer)Enter the designated rig or vehicle number.
- Date and Time of Inspection (Date)Select today's date and current time.
- Fuel Level (Dropdown)Select the current fuel gauge reading.
- Shoreline Charging Status (Multiple choice)Confirm if the vehicle is properly disconnected or maintained.
- Truck Cleanliness Status (Multiple choice)Inspect cab and patient compartment for cleanliness.
- New Vehicle Damage (Multiple choice)Report any new dents, scratches, or mechanical warning lights.
- On-Board Oxygen Tank Pressure (Short answer)Must be a minimum of 500 PSI.
- Portable Oxygen Tank Pressure (Short answer)Must be a minimum of 750 PSI.
- On-Board Oxygen Tank Changed Status (Multiple choice)Was the main tank changed during this check?
- Portable & On-Board Suction Equipment (Multiple choice)Confirm both units are tested, charged, and operational.
- AED Battery & Pad Expirations (Short answer)Confirm pads are unexpired and AED self-test passed.
- Glucose Gel & Occlusive Dressings Expirations (Short answer)Note earliest expiration date found or enter 'Checked - All Valid'.
- OB Kit Expiration Date (Short answer)Enter the expiration date of the obstetrical kit.
- Checklist Inventory Categories (Checkboxes)Confirm presence and condition of standard gear bags.
- Inspection Notes & Deficiencies (Paragraph)Detail any missing items, mechanical problems, or supplies needing replacement.
FAQ
How do I customize this ambulance check template?
Once you copy the template to your Google Drive via Doc2Form, you can easily add, remove, or edit checklist items to match your specific vehicle inventory and local EMS protocols.
Can crew members fill this out on their mobile phones or tablets?
Yes. Google Forms work seamlessly on any mobile device, allowing paramedics and EMTs to complete the rig check directly from the vehicle bay.
How can I track maintenance issues reported during the inspection?
You can connect your Google Form to Google Sheets to automatically log every submission, making it easy to filter for reported vehicle damage or low inventory levels.
Is this template free to use?
Yes, this template is completely free to copy, customize, and deploy for your station or fleet.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.