Are you a healthcare practitioner looking to increase your knowledge and proficiency when it comes to providing life support? Then consider signing up for the Life Support Course Roster, which provides interactive training in topics like basic life support skills, advanced cardiac nursing care, post-resuscitation management, prehospital trauma care and pain management. Developed by experts in the medical field, this course is designed to ensure that all who attend have an insight into the latest research and best practice guidelines from both inside and outside of the classroom. Read on to find out more about how enrolling in this comprehensive course can equip you with lifesaving competencies that are essential for any healthcare professional!
| Question | Answer |
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| Form Name | Life Support Course Roster Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | cardiovascular life pediatric, support pediatric roster, basic life supporta course roster, advanced cardiovascular life support course roster |
American Heart Association Emergency Cardiovascular Care Program
Advanced Cardiovascular Life Support and Pediatric Advanced Life Support
Course Roster Form
Course Information
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Renewal Course |
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Course Director___________________________________________ |
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Instructor/CD |
TC Faculty |
Regional Faculty |
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ACLS |
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Lead Instructor ___________________________________________ |
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ACLS Provider |
ACLS EP Provider |
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Instructor/CD |
TC Faculty |
Regional Faculty |
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Training Center____________________________________________ |
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PALS |
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Site Name________________________________________________ |
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PALS Provider |
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Course Location___________________________________________ |
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Physician Instructor: |
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Address _________________________________________________ |
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City, State ZIP ___________________________________________ |
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Course Start Date/Time_______________ |
Course End Date/Time_________________ |
Total hours of Instruction __________ |
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# of Cards Issued_________ |
Student/Instructor Ratio__________ |
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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 |
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Instr. card Exp. Date |
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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 Course Director |
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ALS Course Roster Revised March 2004, page 1 |
DATE_________________ COURSE ______________________________ COURSE DIR. __________________________________
Course Participants
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ALS Course Roster Revised March 2004, page 2 |
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