Completing the AED Usage Form is an essential part of tracking AED use in Berks County.

Required fields are marked with *

AED Usage Information

Did YOU apply and use the AED?

Victim Information

How was victim found?
CPR initiated?
Was the victim responsive following defibrillation with AED?

EMS and Hospital


The AED stores valuable data about the patient’s heart rhythm. It is important that this information becomes part of the patient’s medical record.

Following your submission, you may pick up a FREE QUIK-PAK (includes replacement electrodes and battery) in the Reading Hospital’s Emergency Department (ED) HIM group. To guarantee timely replacement, please complete the AED Usage Form within 48 hours of AED use and check in with the ED to download your AED and pick up your QUIK-PAK.