Aha Bls Roster 2016 PDF Details

The AHA BLS Roster form is an essential tool in the administration of Basic Life Support (BLS) courses, a vital component of emergency cardiovascular care programs. The form meticulously records the comprehensive details about a BLS course, including whether it's an instructor-led session or a HeartCode® BLS self-paced course, thus serving the purpose of both organizing and documenting the training process. It captures vital information ranging from the lead instructor's credentials to the detailed breakdown of the course's schedule and logistical particulars, such as location, timing, and student-to-manikin ratios. Additionally, the roster tracks the issuance of completion cards, ensuring that participants and instructors are accredited accurately according to their participation and performance. Beyond its function as a record-keeping instrument, the roster underscores the commitment to rigor and transparency, as evidenced by the lead instructor's verification that the course adheres to the American Heart Association's (AHA) guidelines. Furthermore, it provides spaces for capturing participant details and instructional support, reinforcing its role as a comprehensive document for ensuring quality and accountability in life-saving training courses. This form represents a critical junction between course administration and quality control, embodying the AHA's dedication to equipping individuals with the knowledge and skills to respond to cardiovascular emergencies effectively.

QuestionAnswer
Form NameAha Bls Roster 2016
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesbls course roster, bls roster pdf, aha healthcare provider roster, aha bls roster

Form Preview Example

Basic Life Support Course Roster

Emergency Cardiovascular Care Programs

  Course Information

……BLS Course (instructor-led)

……HeartCode® BLS

……BLS Instructor

Lead Instructor __________________________________________

Lead Instructor ID#

Card Expiration Date

Training Center

Training Center ID#

Training Site Name (if applicable)

Address

City, State ZIP

Course Location

Course Start Date/Time

 

 

Course End Date/Time

 

 

Total Hours of Instruction

 

 

No. of Cards Issued

 

 

Student-Manikin Ratio

 

 

Issue Date of Cards

 

 

 

 

 

 

 

 

 

 

 

 

 

Assisting Instructor

(Attach copy of instructor aligned with a TC other than the primary TC)

 

 

 

 

 

 

 

 

 

Name and Instructor ID#

Card Exp. Date

Name and Instructor ID#

Card Exp. Date

 

 

 

 

 

 

 

 

1.

 

 

5.

 

 

 

 

 

 

 

 

 

 

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I verify that this information is accurate and truthful and that it may be confirmed. This course was taught in

accordance with AHA guidelines.

 

 

 

 

 

 

 

 

 

Signature of Lead Instructor

 

 

Date

 

 

KJ1216  BLS  4/16  © 2016 American Heart Association

Course Participants

Date

 

Course

 

Lead Instructor

 

Lead Instr. ID#

 

 

 

 

 

 

 

 

 

 

 

 

Name and Email

 

 

 

 

Complete/

Remediation/Date

 

 

Mailing Address/Telephone

 

Completed

Please PRINT as you wish your name to appear on your card. Please print

 

 

Incomplete

 

email address legibly.

 

 

 

 

(if applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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 8.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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KJ1216  BLS  4/16  © 2016 American Heart Association

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basic life support roster empty fields to complete

Type in the expected details in the space I verify that this information is, Signature of Lead Instructor, Date, and KJ BLS American Heart.

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It's essential to write down certain data in the section Course Participants, Date Course Lead Instructor Lead, Name and Email Please PRINT as you, Mailing AddressTelephone, Complete Incomplete, and RemediationDate Completed if.

basic life support roster Course Participants, Date Course Lead Instructor Lead, Name and Email Please PRINT as you, Mailing AddressTelephone, Complete Incomplete, and RemediationDate Completed if fields to insert

The KJ BLS American Heart field is the place where both parties can indicate their rights and obligations.

Entering details in basic life support roster part 4

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