Meriter Hospital Community Training Center
2015 – ACLS for Health Care Providers Registration Form
Complete and return this form with your payment to reserve your class enrollment.
Payments can be made via check or credit card – more details can be found on the next page.
Indicate which date you wish to attend.
Registrations received after the registration ends will not be considered.
The course will present the information standards and skills developed by the American Heart Association for Advanced Cardiac Life Support certification and recertification. The material will be presented through the use of lecture, interactive discussions and skills sessions. Participants will complete both written and performance examinations.
Upon completion of this course, participants will be able to direct a team of health care providers in a simulated cardiac arrest situation. In addition, participants will learn such skills as airway management, defibrillation/ cardioversion and use of an AED, application of therapeutic modalities based on recognition of dysrhythmias.
Recognition (2 day course)
Jan 5-6, 2015
Feb 2-3, 2015
Mar 2-3, 2015
Apr 6-7, 2015
May 4-5, 2015
June 1-2, 2015
July 6-7, 2015
Aug 3-4, 2015
Sept 8-9, 2015
Oct 5-6, 2015
Nov 2-3, 2015
Dec 7-8, 2015
Recertification (1 day course)
Jan 5, 2015
Feb 2, 2015
Feb 10, 2015
Mar 2, 2015
Mar 10, 2015
Apr 6, 2015
Apr 14, 2015
May 4, 2015
May 12, 2015
June 1, 2015
June 9, 2015
Aug 3, 2015
Aug 11, 2015
Sept 8, 2015
Sept 15, 2015
Oct 13, 2015
Nov 2, 2015
Nov 10, 2015
Dec 14, 2015
This class is offered through our partner, Center for Healthcare Excellence and Simulation. To view the class schedule and register, please visit www.CHESwi.org.
Physicians, nurses and paraprofessionals involved in critical care/emergency care situations.
• ECG interpretation skills required. Must be able to identify static and dynamic rhythms.
• All applicants should have a current Health Care Provider CPR card at registration. If you are not current in CPR, please arrange to do so as soon as possible, hopefully before your ACLS course.
• All renewal candidates need to submit a previous ACLS (Advanced Cardiac Life Support) card. This can be presented at registration.
• It is necessary that the renewal participant be thoroughly familiar with all ACLS concepts. The focus of the renewal portion of the course is designed toward an update of current ACLS protocols and skills and successful skills demonstration / validation.
Class materials will be mailed upon confirmation of payment to the address indicated on registration form above .
Statement of Accreditation: Meriter Hospital is accredited by the Wisconsin Medical Society to provide continuing medical education for physicians.
AMA/PRA Designation Statement: Meriter Hospital designates ACLS Recognition for a maximum of 16 hours in category 1 credit and ACLS Renewal for a maximum of 8 hours in category 1 credit towards the AMA Physician’s Recognition Award. Participants should claim only those hours of credit that he/she actually spent in the educational activity.
The American Heart Association strongly promotes knowledge and proficiency in ACLS and has developed instructional materials for this purpose. Use of these materials in an educational course does not represent course sponsorship by the American Heart Association, and any fees charged for such a course do not represent income to the association.