• External AHA Wrap Up

    Please complete this at the conclusion of your course.

  • Instructors who are being compensated by APHE--please use the INTERNAL WRAP UP

  • Course Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • ARC Add-Ons (Check ALL that apply)*
  • ARC Lifeguard Add-Ons (Check ALL that apply)*
  • CPR Modules Being Taught*

  • eCards for Heartsaver First Aid CPR AED and Heartsaver CPR AED classes & skills sessions always include Adult CPR AED. Indicate if you also taught child and/or infant CPR AED.

  • Pediatric First Aid CPR AED classes & skills sessions always includes Child & Infant CPR AED AND First Aid (optional Adult CPR AED). Indicate if you also taught Adult CPR AED. eCards are always Heartsaver Pediatric First Aid CPR AED eCards ($24/eCard).

  • eCards for Heartsaver First Aid Classes & Skills Sessions are always standard eCards ($24/eCard).

  • CPR Modules Taught*
  • First Aid Course Taught (AHA)*

  • eCards for TOTAL First Aid CPR AED classes & skills sessions are always standard Heartsaver eCards ($24/eCard).

  • Heartsaver eCard*
  • AHA Guidelines*
  • Any Students under age 18?*

  • Ensure that the parents of students who are not yet 18 years of age have been sent and completed the APHE Youth Participant Agreement & Permission Form. AHA eCards will not be issued to students until this has been received by APHE.

  • List All Students Under Age 18 in This Class or Skills Session*
    Rows

  • Email Skills Session certificates or other paperwork to entry@aphed.com.

  • APHE TC Equipment Disinfection Verification

    All equipment and surfaces will be cleaned and disinfected with a commercial germ-killing disinfectant after each course by the following process:

    1. Put on new, clean disposable gloves.
    2. As needed, clean any soiled surfaces with a wet paper towel; then, dispose of the paper towl.
    3. Apply disinfectant to all surfaces. The surfaces should remain wet for at least six (6) minutes.
    4. Wipe any surfaces with clean cloth until dry.
    5. Pack up equipment & other supplies.

  • By signing here, I agree that:

    • This course was taught in accordance with the appropriate AHA or ARC Guidelines and APHE TC Policies;
    • The course equipment was thoroughly and completely disinfected following the above APHE TC Equipment Disinfection Verification.
  • Should be Empty: