Set Up an External AHA Class
Please complete this to report your upcoming courses.
Access Code
Lead Instructor
*
Please select name from list.
Lead Instructor Email
*
example@example.com
Class(es) Location Name
*
Class(es) Location Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
AHA Course
*
Please Select
BLS Provider
BLS Renewal
BLS Skills Session
Heartsaver First Aid CPR AED
Heartsaver First Aid CPR AED Skills Session
Heartsaver CPR AED
Heartsaver CPR AED Skills Session
Heartsaver First Aid
Heartsaver First Aid Skills Session
Heartsaver Pediatric First Aid CPR AED
Heartsaver Pediatric First Aid CPR AED Skills Session
Family & Friends CPR
Bloodborne Pathogens
ACLS Provider (2 day)
ACLS Update (1 day)
ACLS Skills Session
PALS Provider (2 day)
PALS Update (1 day)
PALS Skills Session
ACLS-EP Provider
PEARS Provider
CPR Skills Being Taught (Check ALL that apply)
*
Adult
Child
Infant
First Aid Course Taught
*
Basic (Does Not Meet OSHA Requirements)
Total (Meets OSHA Requirements)
Course Date & Start Time
*
/
Month
/
Day
Year
Hour Minutes
AM
PM
AM/PM Option
Additional Instructors
*
Type names of additional instructors (if applicable), no autofill for this field
TF Monitoring Instructor for Renewal
*
No
Yes
If multiple classes with the same instructor(s) at the same location, add additional dates and times here
*
If different classes, locations, or instructors, please create a new form
Submit
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