Bls Course Roster Details

Aha Bls Roster 2016 is a list of the most recent and up-to-date sources for legislation. This roster is updated as new legislation emerges, so it is always current and accurate with all amendments to date. The AHA website offers information on legislative updates from legal scholars in over 30 countries around the world. Aha bls roster 2016 also includes links to other resources such as scholarly articles, international news and blog posts related to law and politics.

We've collected some interesting facts about the aha bls roster 2016. You will have the assumed time it might require you to complete the form and a few extra details.

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

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American Heart Association Emergency Cardiovascular Care Program

Basic Life Support for Healthcare Provider

Course Roster Form

Course Information

New Course

Renewal Course

Lead Instructor___________________________________________

 

 

Status: BLS Instr.

BLS TCF/RF

Healthcare Provider Course:

Status Renewal Date: _______________________________________

This course includes all of the Healthcare Provider core components:

 

 

 

 

Training Center____________________________________________

 

 

Site Name________________________________________________

 

 

 

Course Start Date/Time_______________

Course End Date/Time_________________

Total hours of Instruction __________

# of Cards Issued_________

Student/Manikin Ratio__________

Issue Date of cards________________

 

 

 

 

 

Assisting Instructors / Specialty Faculty (Attach copy of instructor card for instructors aligned with other than primary TC)

Name

Instr. card Exp. Date

Module / Station

Name

Instr. card Exp. Date

Module / Station

1.

 

 

5.

 

 

2.

 

 

6.

 

 

3.

 

 

7.

 

 

4.

 

 

8.

 

 

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

HCP Course Roster March 2004, page 1

DATE_________________ COURSE Healthcare Provider

INSTRUCTOR ________________________________

 

Course Participants

 

 

 

 

 

 

 

NAME

 

 

 

Complete/

Remediation/

 

Exam

Please PRINT as you wish your name to

Address

 

Telephone

Date

 

 

Incomplete

 

Score

appear on your card.

 

 

 

Completed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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HCP Course Roster March 2004, page 2

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