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PLG Manikin Maintenance
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Trainers Name
Choose
Andy Smart
David Perch
Amanda Wise-Hall
Tom McMahon
Ethan Pilley
Brian Pemberton
Brodie Wyatt
Amelia Percival
Tim Harris
Simon Moore
Lara Moore
Mark Shakles
Julie Marshall
David Cooper
Connor Sullivan
Date
MM
/
DD
/
YYYY
PLG Adult 1
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Junior 1
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To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Infant 1
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Adult 2
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Junior 2 (Missing)
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To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Infant 2
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Adult 3
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Junior 3
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Infant 3 (MISSING)
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Adult 4
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Junior 4
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Infant 4
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Family 1 Adult
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Family 1 Junior
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Family 1 Infant
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Family 2 Adult
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Family 2 Junior
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
PLG Family 2 Infant
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
Electronic Adult
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To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
Choking Charlie
Select more than one option where needed.
To report any damage select "Other" then describe the damage.
Disinfect
Lung Face Change
Other:
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