Basic Life Support Instructor Interest Form

Thank you for your interest as an American Heart Association Basic Life Support Instructor. Please complete the information below and attach a copy of your AHA Basic Life Support certification. In order to register for an instructor course you must:

be at least 18 years of age on the date of class
certified as an American Heart Association Basic Life Support (BLS) Provider

The American Heart Association BLS Instructor Course certifies the participant to teach the BLS for Healthcare Providerse (BLS) Course, renewal course, and BLS Skill Sessions. In addition, instructors may teach all the AHA Heartsaver programs including: adult CPR, child CPR, infant CPR, AED use, first aid, pediatric CPR/first aid, and bloodborne pathogens. BLS Instructor certification is valid for a period of two (2) years.

Course price includes the BLS Instructor Classroom course, BLS Instructor Essentials eLearning course, as well as monitoring of your first class as required by the AHA.

The classroom portion covers American Heart Association procedures, course guidelines and agendas, instructor challenges, classroom set-up, learning theory, administrative support, and instructor-candidate teaching demonstrations. .

NOTE: Students must hold a current BLS for Healthcare Provider certification from the American Heart Association to be eligible to take this course. The course fee of $279 does NOT include materials needed to teach your first class (BLS Provider DVD, manual, manikins, AED trainers, BVMs, and associated student supplies).

To get started, complete the information below. Once prerequisites are met, instructor candidates will receive an invoice to complete registration.

Name *

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Email *

example@example.com

Phone Number *

Area Code Phone Number

Class date you wish to schedule *

Based on availability

Reason to become an instructor: *

Are you currently a healthcare provider? *

Yes No

This course will require the AHA BLS Instructor Manual in order to attend class. Instructor eManuals can be purchased from Moon Valley CPR or you may purchase on your own. *

AHA BLS Provider Manuals are non-refundable

We offer instructor bridging opportunities for American Red Cross. If you are interested in becoming a Red Cross Instructor, choose a bridge class to request more information

In order to register, you MUST be AHA Basic Life Support certified. 100% online Basic Life Support classes (no in person skills with an instructor was performed) will not be accepted. Submitted forms will be dismissed for expired certifications or certifications that do not meet the requirements for this class *

Browse Files

Please upload a copy of your AHA Basic Life Support certification

AHA Basic Life Support Instructor