BLS COURSE APPROVAL FORM
Instructors wishing to teach a BLS course outside of the Resuscitation Program should submit a course approval form for each course. If rental equipment is required, please complete this form at least 3 weeks in advance. If no rental equipment is required, please submit this form at least 1 week in advance.
You should receive a course approval or denial and equipment reservation confirmation from the BLS Coordinator within 3 business days of submission. Submission of a course approval form does not automatically guarantee course approval or equipment reservation.
*All courses are subject to monitoring by Resuscitation Program Training Centre Faculty*
Course Type
Healthcare Provider Initial
Healthcare Provider Renewal
Heartsaver AED (Adult/Child)
Heartsaver AED (Adult/Child/Infant)
Heartsaver CPR (Adult/Child)
Heartsaver CPR (Adult/Child/Infant)
Heartsaver First Aid with CPR & AED
Heartsaver First Aid
Pediatric Heartsaver First Aid with CPR & AED
Pediatric Heartsaver First Aid
Family & Friends (Adult/Child)
Family & Friends (Adult/Child/Infant)
Internal/External
This course will be taught INTERNAL to the Vanderbilt System
This course will be taught EXTERNAL to the Vanderbilt System
Lead Instructor
Assisting Instructor/s
Course Date
month
X
<<
<
today
>
>>
S
M
T
W
T
F
S
Start Time
End Time
Do you need to hire equipment?
Yes
No
If Yes, what equipment do you need? Please specify VHS or DVD
Exact Location of Course
Expected Number of Students
Email of Lead Instructor