CFR Registration Form Banner

Please complete this form to register the location of a defibrillator with the free St John Community First Responder program.


Registration Type


Organisation


Location

(Physical address - if there is no street number, please provide the nearest cross street/s)

Defibrillator type

Postal Address

(if different to physical location)


Key Contact Information

e.g. reception/security/admin

The St John Operations Centre would call this number in an emergency


Liaison Person 1

(A contact for administration matters only)


Liaison Person 2

(A contact for administration matters only)


Public Usage

If you have any queries about completing this form please contact the St John Community First Responder team on (08) 9334 1418.