Instructor Material Check Form
Please double check to make sure you have included everything. Also, please make sure to use your AHA Email that we have in the system or you will be marked as Not Submitted.
Name
First Name
Last Name
Email
*
Please use your AHA email.
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select your current discipline(s):
*
Heartsaver
BLS
ACLS
ACLS EP
Please check which Instructor Manuals you currently have:
Heartsaver Instructor Manual
BLS Instructor Manual
ACLS Instructor Manual
Please check which Instructor Videos you currently have:
Heartsaver Instructor Videos
BLS Instructor Videos
ACLS Instructor Videos
Upload a photo of your receipt:
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Please follow the directions at the top of the form to find your receipt.
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