Early Access to Defibrillation Program - Registration Online

 
Ambulance Tasmania

Ambulance Tasmania can provide on request information about nearby cardiac arrests and other incidents where the victim may benefit from use of an Automated External Defibrillator (AED). Use this form if you have read the Early Access to Defibrillation Program Information Sheet and wish to subscribe to this information service. If you have more than one AED, please select the option to start this form again once you have submitted information for the first AED. 

Alternatively, you can download a PDF version of this form and post or email it to us. 

Are you updating an existing registration? *
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Contact details
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(Maximum of three phone numbers)
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AED location
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What times is your AED generally available?

(For example only during business hours, or only open in summer … please be as detailed as possible if there are restrictions. AT does not guarantee to be able to restrict the times you will receive notifications but will endeavour to restrict the information feed to times your AED is available for use.)

Mon:        
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AED specifications
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Research
How did you hear about the Early Access to Defibrillation Program?

Disclaimer

I have read and understood the Early Access to Defibrillation Program Information Sheet and understand that Ambulance Tasmania may choose to provide incident information via telephone to the specified numbers if there is an applicable cardiac arrest ("incident") near the AED Location shown above. I understand that by providing incident information Ambulance Tasmania is not requesting my or any other person’s assistance, that I am under no obligation whatsoever to provide any assistance or otherwise take any action in respect of an incident, and that anything I do with the information provided by Ambulance Tasmania is entirely at my own initiative and entirely at my own risk.