As a manager, you know the importance of having an Aha roster form filled out and up to date. This form allows you to track the progress of your team members and ensure that everyone is meeting their goals. Now there's an easy way to create and manage this important form - with the fillable Aha roster form. This online tool makes it simple to gather information about your team members' progress and keep your Aha roster current.
Before you decide to fill out fillable aha roster form, you should learn more in regards to the type of form you are going to work with.
Question | Answer |
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Form Name | Fillable Aha Roster Form |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | aha instructor roster form, aha roster fillable, cpr roster, aha bls roster sheet forms |
American Heart Association Emergency Cardiovascular Care Program
Heartsaver AED
Course Roster Form
Course Information
Lead Instructor___________________________________________
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Status: BLS Instr. |
HS Instr. |
BLS IT |
BLS TCF/RF |
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Heartsaver AED Provider Course: |
Status Renewal Date: _______________________________________ |
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This course included the following Heartsaver AED core components: |
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(Check all that apply) |
Adult |
Training Center____________________________________________ |
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Child CPR and Child AED |
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Infant CPR |
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Site Name________________________________________________ |
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Course Start Date/Time_______________ |
Course End Date/Time_________________ |
Total hours of Instruction __________ |
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# of Cards Issued_________ |
Student/Manikin Ratio__________ |
Issue Date of cards________________ |
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Assisting Instructors / Specialty Faculty (Attach copy of instructor card for instructors aligned with other than primary TC)
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Instr. card Exp. Date |
Module / Station |
Name |
Instr. card Exp. Date |
Module / Station |
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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.
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Signature of Lead Instructor |
Date |
Heartsaver AED Course Roster March 2004, page 1
DATE_________________ |
COURSE Heartsaver AED |
INSTRUCTOR ________________________________ |
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Course Participants |
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NAME |
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Complete/ |
Adult |
Child CPR/AED |
Infant CPR |
Remediation/ |
Exam |
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Please PRINT as you wish your |
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Telephone |
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Incomplete |
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Score |
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name to appear on your card. |
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Completed |
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Heartsaver AED Course Roster March 2004, page 2