School, Workplace, or Sports Facility Name)

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Name & Address _____________________________________________________________________

Emergency Phone#Insert #s for operating -hours & after-hours, may be office during operating hours______

Cross Streets      _________________________________________________________________________

AED Location ______________________________ AED Location __________________________

AED Location ______________________________ AED Location __________________________

AED Location ______________________________ AED Location __________________________

(School, Workplace, or Sports Facility Name)

CARDIAC EMERGENCY RESPONSE TEAM PROTOCOL

IMPORTANT: This is a draft document intended for use in formulating a plan for adoption by a school/school district. Medical and legal counsel for the school/school district should review this Plan before implementation. It is the responsibility of the school/school district to ensure that the Cardiac Emergency Response Plan as adopted is consistent with local, state, and federal law.

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