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AED Purchase Inquiry Form

If you are interested in purchasing or have questions about purchasing an AED, please fill out the form below to the best of your ability and we will contact you shortly!

Preferred method of contact
Phone Call
Text
Email
Either/ Any of the above

Finding the right AED

Where will the AED be located?
Business/ Workplace
School
Home
Public Community Location
Hotel
Other
Would the AED be potentially used for infants/ children at the desired location?
Yes
No

Children younger than 8 yr old (~55 lbs) need special parts.

What is the environment like where the AED would be primarily used?

Select all that apply.

Select the applicable language(s) of the potential user
English only
Spanish only
English and/or Spanish
What is the potential rescuers level of training on the use of an AED?
All persons/ rescuers on-site are trained to use an AED (active certification)
Some persons/ rescuers on-site are trained to use an AED
We are new at this, no one has any formal or active training
Where will the AED be stored?
I need to add a cabinet to this purchase
In the AED cabinet I already own
In a vehicle, it will travel with me
Unsure yet
What is your budget for this AED unit purchase?
I want to purchase the best technology
Middle of the Road option, please
Working with a limited budget
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