Registration Form

Registration Form

BLS, ACLS and PALS Certification Classes

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Name *

First Name Last Name
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Email *
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I am: *

BMC Faculty, Staff or Employee (Physician, NP, PA, Technician, Pharmacist, etc...) Member of the BMC Nursing Department (RN, LPN, CNA, etc...) Current BMC Resident or Fellow Employee of a BMC affiliated Community Health Center Faculty, Staff, Student or Employee of BU School of Dental Medicine BMC Travel or Dialysis Nurse, BUAP Employee, BUSM Student or Graduating BMC Resident Medical Professional from another facility
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BMC Faculty and Staff

Physician, Psychologists, PA, NP, RT, Technician, MA, PT, etc...

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BMC ID Number *
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Position at BMC: *
i.e. MD, DO, CRNA, Resp Therapist, etc... URL is not defined
BMC Department *
i.e. Emergency Medicine, GIM, Cath Lab, Neuro, etc... URL is not defined
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Please Register me for: *

Basic Life Support Only (BLS) Advanced Cardiovascular Life Support- Initial Certification Advanced Cardiovascular Life Support - Recertification Pediatric Advanced Life Support- Initial Certification Pediatric Advanced Life Support- Recertification
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Optional: Add BLS Certification to ACLS or PALS classes *

No Yes
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Members of the BMC Nursing Department

RN, LPN, CNA, etc...

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BMC ID Number? *
i.e. 10012345 URL is not defined
Position at BMC? *
i.e. RN, C.N.A., L.P.N, .... URL is not defined
BMC Department? *
i.e. M4W, MICU, ED, PICU, etc... URL is not defined
Please Register me for: *

Advanced Cardiovascular Life Support- Initial Certification Advanced Cardiovascular Life Support - Recertification Pediatric Advanced Life Support- Initial Certification Pediatric Advanced Life Support- Recertification
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If you would like to add BLS certification to your ACLS or PALS class-

1- Check your Workday Learning "Required" section to see if Nursing Education has already assigned HeartCode BLS (It is automaticly assigned about 60 days prior to your expiration)

2- If you have not been assigned HeartCode BLS in Workday- Contact Lisa Falanga in Nursing Education to request it.

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BMC Residents and Fellows

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BMC ID Number? *
i.e. 10012345 URL is not defined
Position at BMC? *
i.e. PGY-1 Resident, PGY-3 Resident, Fellow, etc... URL is not defined
BMC Department? *
i.e. Rheumatology, Emergency Medicine, BCRP Pedi, etc... URL is not defined
Please Register me for: *

Advanced Cardiovascular Life Support- Initial Certification Advanced Cardiovascular Life Support - Recertification Pediatric Advanced Life Support- Initial Certification Pediatric Advanced Life Support- Recertification
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Optional: Add BLS Certification to Resident ACLS or PALS classes *

No Yes
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Employee of BMC Affiliated Community Health Center

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BMC ID Number?
i.e. 10012345 or U123454566 URL is not defined
Level of Certification? *
i.e. MD, RN, Technician, etc... URL is not defined
Name of Community Health Center? *
i.e. Codman Square, East Boston, South Boston, etc... URL is not defined
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BUSM Student, BUSM Graduate or Graduating BMC Resident or Fellow

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BMC or BU ID number? *
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What is your current status? *

BUSM Student/Graduate Graduating BMC Resident/Fellow BMC Travel or Dialysis Nurse Employee of BUAP ( Copley Square Medical Practice)
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Check Out

Select the class/classes you would like to register for

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My Classes *

Basic Life Support Certification (BLS) HeartCode BLS with in-person skills session. (Can be taken alone or added to ACLS or PALS)

$ 75.00

Advanced Cardiovascular Life Support Certification (ACLS) HeartCode ACLS with in-person skills session

$ 275.00

Pediatric Advanced Life Support Certification (PALS) HeartCode PALS certification with in-person skills session

$ 275.00

Total

$ 0.00

BMC Faculty and Staff