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ECC
Emergency Cardiovascular Care
Course Card Reference Guide
90-1801 3
/11
This card c
ontains uniq
ue security
features to
protect aga
inst forgery.
PEEL
HERE
Healthcar
e
Provider
This card c
ertifies that
the above
individual h
as success
fully
completed
the cognitiv
e and skills
evaluations
in accorda
nce with
the curriculu
m of the A
merican He
art Associa
tion BLS fo
r Healthcar
e
Providers
(CPR and
AED) Progr
am.
Issue Date
Recomme
nded Rene
wal Date
H E AL T H
C A RE P
R OV I D
E RH E A
L T HC A R
E PR O
V I DE R
Training
TC ID #
Center Nam
e
TC
TC
Info
City, State
ZIP
Phone
Course
Location
Instructor
Inst. ID #
Name
Holders
Signature
2011 Am
erican Hear
t Associatio
n Tampe
ring with thi
s card will a
lter its appe
arance. 9
0-1801
90-1806 3/11
This card contains unique security features to protect against forgery.
PEELHERE
ACLSProviderThis card certifies that the above individual has successfully
completed the cognitive and skills evaluations in accordance
with the curriculum of the American Heart Association Advanced
Cardiovascular Life Support (ACLS) Program.
Issue Date
Recommended Renewal Date
ADVANCED CARDIOVASCULAR LIFE SUPPORTADVANCED CARDIOVASCULAR LIFE SUPPORT
Training
TC ID #
Center NameTC
TC
Info City, State ZIP Phone
CourseLocationInstructor
Inst. ID #
Name
HoldersSignature 2011 American Heart Association Tampering with this card will alter its appearance. 90-1806
September 2011
90-1817 3
/11
This card c
ontains uniq
ue security
features to
protect aga
inst forgery.
PEEL
HERE
TC
TC ID #
Alignment
TC
TC
Address
Phone
TCCity,
State
ZIP
Instructor
ID #
Holders
Signature
2011 Am
erican Hear
t Associatio
n Tampe
ring with thi
s card will a
lter its appe
arance. 9
0-1817
This card c
ertifies that
the above
individual i
s an Americ
an Heart
Association
Pediatric A
dvanced Lif
e Support (
PALS) Instr
uctor.
Issue Date
Expiration
Date
P AL S
I NS T
R UC T
O R
PALS Inst
ructor
P AL S
I NS T
R UC T
O R
90-1815 3/11
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
PEELHERE
Heartsaver First Aid CPR AEDThis card certifies that the above individual has successfully completed the objectives
and skills evaluations in accordance with the curriculum of the AHA Heartsaver First Aid
CPR AED Program. Optional completed modules are those NOT marked out:
Child CPR AED Infant CPR Written test
Issue Date
Recommended Renewal Date
HEARTSAVER FIRST AID CPR AEDHEARTSAVER FIRST AID CPR AED
Training
TC ID #
Center NameTC
TC
Info City, State ZIP Phone
CourseLocationInstructor
Inst. ID #
Name
HoldersSignature 2011 American Heart Association Tampering with this card will alter its appearance. 90-1815
Contents
i
Preface iii
Card Format 1Security Features 1Guidelines for Card Completion 2
Front of Card, 2000 and Later 2Back of Card, 2000-2010 3Back of Card, 2011 and Later 3Duplication/Replacement of Lost Cards 3
BLS 5BLS National Faculty 5BLS Regional Faculty 5BLS Training Center Faculty 6BLS Instructor 6BLS Healthcare Provider 7
Heartsaver 9Heartsaver Instructor 9Heartsaver Skills Evaluator 9Heartsaver First Aid Instructor 10Heartsaver CPR AED 10Heartsaver CPR 11Heartsaver AED 11Heartsaver First Aid 12Heartsaver First Aid CPR AED 13Heartsaver Pediatric First Aid 13Heartsaver CPR AED in Schools 14Heartsaver CPR in Schools 14
ACLS 15ACLS National Faculty 15ACLS Regional Faculty 15ACLS Training Center Faculty 16ACLS Instructor 16ACLS Provider 17ACLS EP Instructor 17 ACLS Experienced Provider 18
PALS and PEARS 19PALS National Faculty 19PALS Regional Faculty 19PALS Training Center Faculty 20PALS Instructor 20PALS Provider 21PEARS Provider 22
Course Card Index 23
2011 American Heart Association
Preface
iii
Preface
The Course Card Reference Guide is a quality control tool to be used with American Heart Association
(AHA) course cards. The Course Card Reference Guide is not a policy document. See the Program
Administration Manual: Guidelines for Program Administration and Training, third and fourth editions,*
for specific criteria, guidelines, and policy for issuing course cards.
AHA Emergency Cardiovascular Care (ECC) course cards are described throughout this Guide. This
Guide includes samples of available cards for each discipline. Quality Control Checkpoints aid the user
by providing the date the card was introduced, the date the card was withdrawn from use, and how long
the card is recognized.
Course cards are available only to authorized Training Centers with a confidential security code issued
by AHA National Center ECC Programs. Each student who successfully completes an AHA ECC credentialed
course must be issued the appropriate course card, which bears an AHA logo. The Training Center
conducting the course is responsible for card issuance and security through its instructors and training
sites. Each Training Center must document how it maintains card security and accountability. Duplicate
course cards are managed by the Training Center issuing the original card.
For clarification on issues addressed in this Guide or to verify the status of the Training Center that
issued a card, please contact the ECC Customer Support Center at 1-888-CPR-LINE.
* Program Administration Manual, third edition, July 2004, pages 77-79; Program Administration Manual, fourth edition, March 2008, pages 19-20.
Card Format
Card Format
This section describes cards issued for courses that use criteria and materials from the 2000, 2005, and 2010
American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular
Care. These cards have issue dates beginning March 5, 2001, for Basic Life Support (BLS); May 2001 for
Advanced Cardiovascular Life Support (ACLS); January 21, 2002, for Pediatric Advanced Life Support
(PALS); November 29, 2007, for Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS);
and March 5, 2001, for Heartsaver CPR and Heartsaver AED, January 2003 for Heartsaver First Aid,
May 31, 2006, for Heartsaver Pediatric First Aid, April 2006 for Heartsaver CPR in Schools, and Spring 2009
for Heartsaver Skills Evaluator. The 2011 cards begin with BLS Instructor and BLS Healthcare Provider,
March 2011; Heartsaver Instructor, Heartsaver CPR AED, Heartsaver First Aid, and Heartsaver First Aid
CPR AED, April 2011; ACLS Instructor and ACLS Provider, May 2011; and PALS Instructor and PALS
Provider, October 2011.
Security Features
Cardlayout: Each sheet of cards is formatted for printing both sides at the same time. The completed card can be peeled from the sheet and folded to form a 338 218-inch card.
Colordesignation:Each discipline is designated by a color stripe at the top edge of both sides. BLS and Heartsaver are blue, ACLS is red, and PALS and PEARS are purple. The 2005 cards also have a red stripe along the left front edge.
Copyright:The cards have copyright years that begin with 2000.
Highlightedpersonalization: The cards have highlighted areas for the name, issue date, and renewal date.
Lamination: Some professional-level course cards (provider and instructor cards for BLS, ACLS, PALS, and PEARS) are laminated with a matte finish on both sides. A phase-out of this lamination began in 2005. Cards produced in 2006 and later have a lamination film on the back of the card only. Cards produced in 2011 and later do not have a laminated finish on either side.
Print-sidefinish: Tampering with printing on laminated cards (cards produced in 2011 do not have a laminated finish) may dissolve the matte finish, leaving behind a noticeably shiny surface. Tampering with this card will alter its appearance is printed on each card.
1
90-1801 3/11This card contains unique security features to protect against forgery.
PEELHERE
HealthcareProv ider
This card certifies that the above individual has successfully completed the cognitive and skills evaluations in accordance with the curriculum of the American Heart Association BLS for Healthcare Providers (CPR and AED) Program.
Issue Date Recommended Renewal Date
H E A L T H C A R E P R O V I D E R H E A L T H C A R E P R O V I D E R
Training TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1801
90-1801 3/11This card contains unique security features to protect against forgery.
PEELHERE
HealthcareProv ider
This card certifies that the above individual has successfully completed the cognitive and skills evaluations in accordance with the curriculum of the American Heart Association BLS for Healthcare Providers (CPR and AED) Program.
Issue Date Recommended Renewal Date
H E A L T H C A R E P R O V I D E R H E A L T H C A R E P R O V I D E R
Training TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1801
Watermark:All laminated cards have the AHA Heart and Torch logo watermark in light gray on the front and back.
Microprint:All cards with a copyright year of 2006 or later use security microprinting for the information lines. For cards produced in 2006 through 2010, each line is the repeated text AMERICANHEARTASSOCIATION. For cards produced in 2011 and later, the card name in the top bar is the repeated text. For example, the microprint on the BLS Instructor card is BLSINSTRUCTORBLSINSTRUCTOR (see Figure 1).
Viewingmicroprint: The microprint can be viewed with a loupe or magnifying glass, such as that in Figure 2.
Guidelines for Card Completion
The AHA recommends that course cards be stamped, typed, or computer generated to reduce the risk of cards being altered. All AHA cards that are issued must be complete and legible. The content of AHA course cards cannot be altered in any way.
AHA course cards must be completed as follows:
FrontofCard,2000andLater
Thecoursenameispreprintedonthecard.
Indicatethestudentsname(firstname,middleinitial,and last name).
StrikethroughorfillinthecirclesformodulesNOTcompleted, if applicable.
Indicatetheissuedateasa2-digitmonthand4-digityear (01/2011) or a 2-digit month and day and 4-digit year (01/15/2011).
Indicatetherecommendedrenewal/expirationdate,2years from the issue date (2-digit month and 4-digit year only, no exceptions).
Figure 1. Security microprint. Figure 2. A loupe or a magnifying glass can be used to view the security microprint.
90-1800 3/11This card contains unique security features to protect against forgery.
PEELHERE
TC TC ID #Alignment
TC TCAddress Phone
TCCity, State ZIP
InstructorID #
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1800
This card certifies that the above individual is an American Heart Association Basic Life Support (BLS) Instructor.
Issue Date Expiration Date
B L S I N S T R U C T O R
BLSInstructor
B L S I N S T R U C T O R
BLSINSTRUCTORBLSINSTRUCTORBLSINSTRUCTOR
2
90-1815 3/11
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
PEELHERE
Heartsaver
First Aid CPR AED
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA Heartsaver First Aid CPR AED Program. Optional completed modules are those NOT marked out:
Child CPR AED Infant CPR Written test
Issue Date Recommended Renewal Date
HEARTSAVER FIRST AID CPR AED HEARTSAVER FIRST AID CPR AED
Training TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1815
Card Format
Program Administration Manual, fourth edition, March 2008, page 20.
Card FormatBackofCard,2000-2010
IndicatethenameoftheTrainingCenter(TC).
IndicatetheTCsaddressandcontactinformation.
Indicatethelocationofthecourse.
IndicatethefirstandlastnameoftheCourseDirector/LeadInstructor(mustbelegible).
Thestudentmustsignhisorhernameinblackorblueink.
BackofCard,2011andLater
All of the following items are required unless otherwise noted:
IndicatethenameoftheTC.
IndicatetheTCsAHAidentificationnumber.
IndicatetheTCsaddressandcontactinformation.
Indicatethelocationofthecourse.Provideageneraldescriptionofwherethecoursewasconducted.
IndicatethefirstandlastnameoftheCourseDirector/LeadInstructor(mustbelegible).
IndicatetheDirectors/InstructorsAHAidentificationnumber.
Oninstructorcards,indicatethereceivinginstructorsAHAInstructorNetworkidentificationnumber(requiredbyJanuary 1, 2012).
Thestudentorinstructormustsignhisorhernameinblackorblueink.Amissingsignaturedoesnotinvalidatethe card.
Duplication/ReplacementofLostCards
It is the responsibility of the TC to issue a duplicate card if a card is lost, is mutilated, or otherwise becomes unus-able. In such cases the Course Director or Lead Instructor may advise the student to contact the TC that issued the original card, or the Instructor may do so. The TC may set a fee for reissuing a card.
3
BLS
BLS (Basic Life Support)
BLS National FacultyBLS National Faculty (NF) members are BLS Instructors appointed by their respective National ECC
Committees. BLS NF members are responsible for quality assurance and are the educational leadership
fortheBLSProgramwithintheirregionsinstructornetwork.NFmembersarekeyresourcesforthe Regional ECC Committee. The NF status is not transferable between regions or states. This card is not
an acceptable substitute for an instructor card and does not verify instructor status dates.
Quality Control Checkpoints
IssuedatebeginningJuly 2007 Termofappointment Carddesignvaliduntilfurthernotice
Back of Card
AHAECCmissionstatement SignatureofappointedNFmember(inink)
BLS National Faculty
John DoeTerm: July 2011 June 2012
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
John Doehas been appointed as a Basic Life Support National Faculty
for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe PROAD Chair
BLS NationalFaculty
BLS National Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as a Basic Life Support National Faculty
for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe PROAD Chair
BLS NationalFaculty
BLS National Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as a Basic Life Support National Faculty
for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe PROAD Chair
BLS NationalFaculty
KJ0462
R4/10
KJ0462
R4/10
KJ0462
R4/10
BLS Regional FacultyBLS Regional Faculty (RF) members are BLS Instructors appointed by their respective Regional ECC
Committees. BLS RF members are responsible for quality assurance and are the educational leadership
fortheBLSProgramwithintheirregionsinstructornetwork.RFmembersarekeyresourcesforthe regionsTrainingCenters.TheRFstatusisnottransferablebetweenregionsorstates.Thiscardisnot an acceptable substitute for an instructor card and does not verify instructor status dates.
BLS Regional Faculty
John DoeTerm: July 2011 June 2012
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
John Doehas been appointed as a Basic Life Support Regional Faculty
for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair
BLS RegionalFaculty
BLS Regional Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as a Basic Life Support Regional Faculty
for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair
BLS RegionalFaculty
BLS Regional Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as a Basic Life Support Regional Faculty
for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair
BLS RegionalFaculty
KJ0562
R4/10
KJ0562
R4/10
KJ0562
R4/10
Quality Control Checkpoints
IssuedatebeginningJuly 2007 Carddesignvaliduntilfurthernotice Termofappointment
Back of Card
AHAECCmissionstatement SignatureofappointedRFmember(inink)
5
National Faculty cards produced and distributed by AHA National Center
Regional Faculty cards produced and distributed by AHA National Center
BLS
6
BLS Training Center FacultyBLS Training Center Faculty (TCF) members are appointed by their respective Training Centers. BLS TCF
members are responsible for quality assurance and are the educational leadership for all BLS courses within
their Training Center network. TCF members conduct instructor courses, monitor new and renewing instructors,
andconductupdatesfortheTrainingCentersinstructors.Thiscardisnotanacceptablesubstituteforan instructor card and does not verify instructor status.
Quality Control Checkpoints
IssuedatesbeginningJune 2010 Carddesignvaliduntilfurthernotice NameoftheappointingTrainingCenter Monthandyearofappointment Dateforreappointment(monthandyear) TrainingCenteralignment TrainingCenteraddressandcontactinformation FirstandlastnameoftheTrainingCenterCoordinator
(must be legible)
BLS Training Center Faculty
has been appointed as a Basic Life Support Training Center Faculty
for the American Heart Association.
TC Name TC Coordinator
Term RegionKJ0835 BLS 6/10
BLS InstructorBLS Instructors teach lifesaving CPR, AED, and first aid courses for the medical and nonmedical communities.
Although BLS Instructors are not required to have a medical background to teach, most instructors are in a
healthcare field.
90-1800 3/11This card contains unique security features to protect against forgery.
PEELHERE
TC TC ID #Alignment
TC TCAddress Phone
TCCity, State ZIP
InstructorID #
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1800
This card certifies that the above individual is an American Heart Association Basic Life Support (BLS) Instructor.
Issue Date Expiration Date
B L S I N S T R U C T O R
BLSInstructor
B L S I N S T R U C T O R
Quality Control Checkpoints
IssuedatebeginningMarch 23, 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescards70-2916and70-2904
Associated Materials for Instructors
BLSforHealthcareProvidersInstructorManual BLSforHealthcareProvidersStudentManual 2010HandbookofEmergencyCardiovascularCare forHealthcareProviders
HeartsaverFirstAidCPRAEDInstructorManual HeartsaverFirstAid,CPRAED,andFirstAidCPRAED StudentWorkbooks
Quality Control Checkpoints
IssuedatebeginningMarch 5, 2001 CarddesignvalidthroughJune30,2013 Not valid for issue after June 30, 2011, and is
superseded by cards 90-1800 and 90-1807 Expirationdate2yearsfrommonthofissue
Associated Materials for Instructors
BLSforHealthcareProvidersInstructorManual BLSforHealthcareProvidersStudentManual HeartsaverFirstAidCPRAEDInstructorManual HeartsaverFirstAid,CPR,andAEDStudent Workbooks
90-1800 3-card 90-1807 2-card self-mailer
TCF certificate and card printed by Training Center Coordinator using template available on AHA Instructor Network
70-2916 R12/08
Training CenterAlignment
TC AddressContact Info
CourseLocation
TCCoordinator
HoldersSignature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2916
BLS Instructor
This card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the American Heart Association for the Basic Life Support (CPR/AED) Instructor Program.
Issue Date Expiration Date
70-2916 3-card 70-2904 2-card self-mailer
BLS
7BLS
BLS Healthcare ProviderThe BLS for Healthcare Providers Course teaches both single-rescuer and team basic life support skills for
application in both in- and out-of-hospital settings. This course trains participants to promptly recognize
several life-threatening emergencies, give high-quality chest compressions, deliver appropriate ventilations,
and provide early use of an AED. It includes adult, child, and infant rescue techniques.
70-2915 R1/08
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2915
Healthcare Provider
This card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the American Heart Association for the BLS for Healthcare Providers (CPR & AED) Program.
Issue Date Recommended Renewal Date
90-1801 3/11This card contains unique security features to protect against forgery.
PEELHERE
HealthcareProv ider
This card certifies that the above individual has successfully completed the cognitive and skills evaluations in accordance with the curriculum of the American Heart Association BLS for Healthcare Providers (CPR and AED) Program.
Issue Date Recommended Renewal Date
H E A L T H C A R E P R O V I D E R H E A L T H C A R E P R O V I D E R
Training TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1801
Quality Control Checkpoints
IssuedatebeginningMarch 23, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards70-2915and70-2903
Quality Control Checkpoints
IssuedatebeginningMarch 5, 2001 ValidthroughJune30,2013 Not valid for issue after June 30, 2011, and is
superseded by cards 90-1801 and 90-1802 Renewaldate2yearsfrommonthofissue
70-2915 3-card 70-2903 2-card self-mailer
90-1801 3-card 90-1802 2-card self-mailer
Hear tsaver
9Hear tsaver
Heartsaver
Heartsaver InstructorHeartsaver Instructors teach lifesaving CPR, AED, and first aid courses for the nonmedical community.
Heartsaver Instructors are not required to have a medical background to teach.
80-1205 R1/08
Training CenterAlignment
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2000 American Heart Association Tampering with this card will alter its appearance. 80-1205
Heartsaver Instructor
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the American Heart Association for the Heartsaver Instructor Program.
Issue Date Expiration Date
PEELHERE
This card contains unique security features to protect against forgery.
90-1816 3/11This card contains unique security features to protect against forgery.
PEELHERE
TC TC ID #Alignment
TC TCAddress Phone
TCCity, State ZIP
InstructorID #
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1816
This card certifies that the above individual is an American Heart Association Heartsaver Instructor.
Issue Date Expiration Date
Heartsaver
Instructor
HEARTSAVER INSTRUCTOR HEARTSAVER INSTRUCTOR
Quality Control Checkpoints
IssuedatebeginningApril 26, 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescards80-1205and80-1213
Associated Materials for Instructors
HeartsaverFirstAidCPRAEDInstructorManual HeartsaverFirstAid,CPRAED,andFirstAidCPRAED StudentWorkbooks
Quality Control Checkpoints
IssuedatebeginningMay 2002 CarddesignvalidthroughJuly31,2013 Not valid for issue after July 31, 2011, and is
superseded by card 90-1816 Expirationdate2yearsfrommonthofissue
Associated Materials for Instructors
HeartsaverInstructorManual HeartsaverFirstAid,CPR,andAEDStudentWorkbooks
80-1205 3-card 80-1213 2-card self-mailer
90-1816 3-card
Heartsaver Skills EvaluatorThis course provides training where the Skills Evaluator learns to appropriately evaluate the psychomotor
skills performed in Heartsaver skills practice and skills testing sessions by following a self-directed online
learning course. The role of the Heartsaver Skills Evaluator is to coach, if needed, during skills practice and
evaluate psychomotor skills during skills testing. The course does not provide training for instructing
Heartsaver classroom courses.
Quality Control Checkpoints
IssuedatebeginningOctober 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescard80-1216
90-1822 9/11This card contains unique security features to protect against forgery.
PEELHERE
TC TC ID #Alignment
TC TCAddress Phone
TCCity, State ZIP
InstructorID #
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1822
This card certifies that the above individual is an American Heart Association Heartsaver Skills Evaluator.
Issue Date Expiration Date
Heartsaver
Skil ls Evaluator
HEARTSAVER SKILLS EVALUATOR HEARTSAVER SKILLS EVALUATOR
90-1822 3-card
Quality Control Checkpoints
IssuedatebeginningSpring 2009 CarddesignvalidthroughNovember30,2013 Not valid for issue after November 30, 2011, and is
superseded by card 90-1822 Expirationdate2yearsfrommonthofissue
Associated Materials for Skills Evaluators
HeartsaverSkillsEvaluatorManual
Heartsaver Skills Evaluator
Alan Carrington, MDTerm: July 2009 June 2010
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Heartsaver Skills Evaluator
Alan Carrington, MDTerm: July 2009 June 2010
Heartsaver Skills Evaluator
Alan Carrington, MDTerm: July 2009 June 2010
John Doe
Heartsaver skills evaluator
has completed the national cognitive and skills objectives of the American Heart Association Heartsaver Skills Evaluator program.
Term: MMMM YYYYMMMM YYYY ID#: 1234567890Authorizing Training Center: Heartland ECC Training, Dallas TXTC ID: AAA1234 Phone: 214-706-1717
John Doe
Heartsaver skills evaluator
has completed the national cognitive and skills objectives of the American Heart Association Heartsaver Skills Evaluator program.
Term: MMMM YYYYMMMM YYYY ID#: 1234567890Authorizing Training Center: Heartland ECC Training, Dallas TXTC ID: AAA1234 Phone: 214-706-1717
Heartsaver skills evaluator
John Doehas completed the national cognitive and skills objectives of the American Heart Association Heartsaver Skills Evaluator program.
Term: MMMM YYYYMMMM YYYY ID#: 1234567890Authorizing Training Center: Heartland ECC Training, Dallas TXTC ID: AAA1234 Phone: 214-706-1717
80-1216 R
4/10
80-1216 R
4/10
80-1216 R
4/10
80-1216 3-card
Hear tsaver
Heartsaver First Aid InstructorThis card has been discontinued and is no longer valid or available. A phase-out of this position began
on May 1, 2006. The roles and responsibilities have been transferred to BLS Instructor and Heartsaver
Instructor status.
Quality Control Checkpoints
IssuedatebeginningMay 2002 NotvalidafterMay31,2008
70-2965 11-02
AHARegion
CommunityTraining Center
TrainingSite
Instructor
HoldersSignature2000 American Heart Association Tampering with this card will alter its appearance. 70-2965
Heartsaver First Aid InstructorThis card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the American Heart Association for the Heartsaver First Aid Instructor Program.
Issue Date Expiration Date
70-2965 3-card 70-2964 2-card self-mailer
Heartsaver CPR AEDHeartsaver CPR AED is a classroom, video-based, instructor-led course that teaches adult CPR and AED
use,aswellashowtorelievechokinginanadult.ThiscourseteachesskillswiththeAHAsresearch-proven practice-while-watching technique, which allows instructors to observe the students, provide feedback, and
guidethestudentslearningofskills.Infantandchildmodulesareoptional.
Quality Control Checkpoints
IssuedatebeginningApril 26, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards80-1203and80-1211 StrikethroughmodulesNOTcompleted Completedmodulesareunmarkedandvisible AdultCPRAEDmustbetaughtifchildCPRAEDistaught
90-1813 3/11
PEELHERE
Heartsaver
CPR AED
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA Heartsaver CPR AED Program. Optional completed modules are those NOT marked out:
Child CPR AED Infant CPR Written test
Issue Date Recommended Renewal Date
H E A R T S AV E R C P R A E D H E A R T S AV E R C P R A E DTraining TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1813
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
90-1813 3-card 90-1810 2-card self-mailer
10
Hear tsaver
11
Hear tsaver
Heartsaver CPRThis course card and course curriculum were discontinued as of April 26, 2011. Heartsaver CPR was a modular
course that taught lay rescuers how to recognize and treat life-threatening emergencies, including cardiac arrest
and choking for adult, child, and infant victims. Students also learned to recognize the warning signs of heart
attack and stroke in adults and breathing difficulties in children.
Quality Control Checkpoints
IssuedatebeginningMarch 5, 2001 ValidthroughApril30,2013 Not valid for issue after April 26, 2011, and is
superseded by cards 90-1810 and 90-1813 Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible Fourallowedcoursecombinations:
Adult/Child CPR and Choking Infant CPR and Choking Adult/Child CPR With Mask Infant CPR With Mask
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2006 American Heart Association Tampering with this card will alter its appearance. 80-1204
Heartsaver CPR
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA for Heartsaver CPR Program.Modules Completed: A B C D
Issue Date Recommended Renewal Date
80-1204 R1/08
PEELHERE
Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.80-1204 3-card 80-1210 2-card self-mailer
Heartsaver AEDHeartsaver AED taught the basic techniques of adult CPR and use of an AED. Pediatric CPR skills could be
taught if students lived or worked in a setting where children were present. Students also learned to use
barrier devices in CPR and give first aid for choking. The course taught how to recognize the signs of 4 major
emergencies: heart attack, stroke, cardiac arrest, and foreign-body airway obstruction.
Quality Control Checkpoints
IssuedatebeginningMarch 5, 2001 ValidthroughApril30,2013 Not valid for issue after April 26, 2011, and is
superseded by cards 90-1810 and 90-1813 Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible AdultCPR&AEDwasrequiredtobetaughtifchild CPR&AEDwastaught
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2006 American Heart Association Tampering with this card will alter its appearance. 80-1203
Heartsaver AED
80-1203 R1/08
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA for Heartsaver AED Program.Modules Completed: A B C
Issue Date Recommended Renewal Date
PEELHERE
Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.80-1203 3-card 80-1211 2-card self-mailer
Hear tsaver
12
Heartsaver First AidHeartsaver First Aid is a classroom, video-based, instructor-led course that teaches students critical skills
to respond to and manage an emergency in the first few minutes until emergency medical services (EMS)
arrives. Students learn skills such as how to treat bleeding, sprains, broken bones, shock, and other first
aid emergencies.
Quality Control Checkpoints
IssuedatebeginningApril 26, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards80-1202and80-1208 StrikethroughmodulesNOTcompleted Completedmodulesareunmarkedandvisible ThiscourseisforFirstAidonlyanddoesnotinclude
CPR AED
90-1814 3/11
PEELHERE
Heartsaver
F i rst A id
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA Heartsaver First Aid Program.Optional Module completed if NOT marked out: Written test
Issue Date Recommended Renewal Date
HEARTSAVER F IRST A ID HEARTSAVER F IRST A ID
Training TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1814
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
90-1814 3-card 90-1809 2-card self-mailer
The previous Heartsaver First Aid course taught rescuers to effectively recognize and treat adult emergencies
in the critical first minutes until EMS personnel arrive. The course covered general principles of basic first aid,
medical emergencies, and injury emergencies. Optional modules included environmental emergencies, adult
and child CPR and AED, and infant CPR.
Quality Control Checkpoints
IssuedatebeginningJanuary 2003 ValidthroughJuly31,2013 Not valid for issue after July 31, 2011, and is
superseded by cards 90-1809 and 90-1814 Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible AdultCPRwasrequiredifchildCPRwastaught AdultCPR&AEDwasrequiredifchildCPR&AEDwastaught InfantCPRwasnottaughtwithoutadultandchildCPR
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2006 American Heart Association Tampering with this card will alter its appearance. 80-1202
Heartsaver Firs t Aid
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA for Heartsaver First Aid Program.Modules Completed: A B C D E
Issue Date Recommended Renewal Date
80-1202 R3/08
PEELHERE
Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.80-1202 3-card 80-1208 2-card self-mailer
Hear tsaver
Heartsaver First Aid CPR AEDHeartsaver First Aid CPR AED is a classroom, video-based, instructor-led course that teaches students critical
skills needed to respond to and manage a first aid, choking, or sudden cardiac arrest emergency in the first
few minutes until EMS arrives. Students learn skills such as how to treat bleeding, sprains, broken bones,
shock, and other first aid emergencies. This course also teaches adult CPR and AED use. Infant and child
modules are optional.
Quality Control Checkpoints
IssuedatebeginningApril 26, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards80-1202and80-1208 StrikethroughmodulesNOTcompleted Completedmodulesareunmarkedandvisible
90-1815 3/11
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
PEELHERE
Heartsaver
First Aid CPR AED
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA Heartsaver First Aid CPR AED Program. Optional completed modules are those NOT marked out:
Child CPR AED Infant CPR Written test
Issue Date Recommended Renewal Date
HEARTSAVER FIRST AID CPR AED HEARTSAVER FIRST AID CPR AED
Training TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1815
90-1815 3-card 90-1820 2-card self-mailer
13
Hear tsaver
Heartsaver Pediatric First AidHeartsaver Pediatric First Aid is a modular course for the child care industry and others requiring a credential in
pediatric first aid. Students learn how to manage illness and injuries in a child in the first few minutes until
professional help arrives. The course covers first aid basics and medical, injury, and environmental emergencies.
Quality Control Checkpoints
IssuedatebeginningMay 31, 2006 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2006 American Heart Association Tampering with this card will alter its appearance. 80-1201
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA for Heartsaver Pediatric First Aid Program.Modules Completed: A B C D E F
Issue Date Recommended Renewal Date
80-1201 R3/08
PEELHERE
Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.
Heartsaver Pediatric First Aid
80-1201 3-card 80-1209 2-card self-mailer
Hear tsaver
14
Heartsaver CPR AED in SchoolsHeartsaver CPR AED in Schools uses the Heartsaver First Aid CPR AED course to teach middle and high
school students critical skills needed to respond to and manage a sudden cardiac arrest, choking, or first aid
emergency in the first few minutes until EMS arrives. This course teaches adult CPR and AED use. Infant and
child modules are optional. Students may also learn skills such as how to treat bleeding, sprains, broken bones,
shock, and other first aid emergencies. The course is presented in several modules, giving schools and AHA
Instructors the flexibility to teach the course over several class periods.
Quality Control Checkpoints
IssuedatebeginningSeptember 8, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescard80-1200 StrikethroughmodulesNOTcompleted Completedmodulesareunmarkedandvisible
90-1821 8/11
PEELHERE
Heartsaver
CPR AED in Schoo lsThis card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA Heartsaver CPR AED Program. Optional completed modules are those NOT marked out:
Child CPR AED Infant CPR First Aid Written test
Issue Date Recommended Renewal Date
HEARTSAVER CPR AED IN SCHOOLS HEARTSAVER CPR AED IN SCHOOLSTraining TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1821
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
90-1821 3-card
Heartsaver CPR in SchoolsHeartsaver CPR in Schools is designed to teach middle and high school students lifesaving CPR and AED
skills. Especially designed with the teen audience in mind, the course appeals to students through a unique
training video featuring teen interviews and edgy video footage. The course is presented in several modules,
giving schools the flexibility to teach the course over several class periods.
Quality Control Checkpoints
IssuedatebeginningApril 2006 ValidthroughDecember31,2013 Not valid for issue after December 31, 2011,
and is superseded by card 90-1821 Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2006 American Heart Association Tampering with this card will alter its appearance. 80-1200
Heartsaver CPR in Schools
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the AHA for Heartsaver CPR in Schools Program.Modules Completed: A B C D E
Issue Date Recommended Renewal Date
80-1200 R12/08
PEELHERE
Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.80-1200 3-card
ACLS
ACLS (Advanced Cardiovascular Life Support)
ACLS National FacultyACLS National Faculty (NF) members are ACLS Instructors appointed by their respective National ECC
Committees. ACLS NF members are responsible for quality assurance and are the educational leadership
fortheACLSProgramwithintheirregionsinstructornetwork.NFmembersarekeyresourcesfortheRegionalECC Committee. The NF status is not transferable between regions or states. This card is not an acceptable
substitute for an instructor card and does not verify instructor status dates.
Quality Control Checkpoints
IssuedatebeginningJuly 2007 Termofappointment Carddesignvaliduntilfurthernotice
Back of Card
AHAECCmissionstatement SignatureofappointedNFmember(inink)
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
ACLS National Faculty
John DoeTerm: July 2011 June 2012
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
John Doehas been appointed as an Advanced Cardiovascular Life Support
National Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe PROAD Chair
ACLS NationalFaculty
ACLS National Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as an Advanced Cardiovascular Life Support
National Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe PROAD Chair
ACLS NationalFaculty
ACLS National Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as an Advanced Cardiovascular Life Support
National Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe PROAD Chair
ACLS NationalFaculty
KJ0462
R4/10
KJ0462
R4/10
KJ0462
R4/10
ACLS Regional FacultyACLS Regional Faculty (RF) members are ACLS Instructors appointed by their respective Regional ECC
Committees. ACLS RF members are responsible for quality assurance and are the educational leadership
fortheACLSProgramwithintheirregionsinstructornetwork.RFmembersarekeyresourcesfortheregionsTraining Centers. The RF status is not transferable between regions or states. This card is not an acceptable
substitute for an instructor card and does not verify instructor status dates.
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
ACLS Regional Faculty
John DoeTerm: July 2011 June 2012
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
John Doehas been appointed as an Advanced Cardiovascular Life Support
Regional Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair
ACLS RegionalFaculty
ACLS Regional Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as an Advanced Cardiovascular Life Support
Regional Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair
ACLS RegionalFaculty
ACLS Regional Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as an Advanced Cardiovascular Life Support
Regional Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair
ACLS RegionalFaculty
KJ0562
R4/10
KJ0562
R4/10
KJ0562
R4/10
Quality Control Checkpoints
IssuedatebeginningJuly 2007 Carddesignvaliduntilfurthernotice Termofappointment
Back of Card
AHAECCmissionstatement SignatureofappointedRFmember(inink)
15
National Faculty cards produced and distributed by AHA National Center
Regional Faculty cards produced and distributed by AHA National Center
ACLS
16
ACLS Training Center FacultyACLS Training Center Faculty (TCF) members are appointed by their respective Training Centers. ACLS TCF
members are responsible for quality assurance and are the educational leadership for all ACLS courses
within their Training Center network. TCF members conduct instructor courses, monitor new and renewing
instructors,andconductupdatesfortheTrainingCentersinstructors.Thiscardisnotanacceptablesubstitutefor an instructor card and does not verify instructor status dates.
Quality Control Checkpoints
IssuedatesbeginningJune 30, 2010 Carddesignvaliduntilfurthernotice NameoftheappointingTrainingCenter Monthandyearofappointment Dateforreappointment(monthandyear) TrainingCenteralignment TrainingCenteraddressandcontactinformation FirstandlastnameoftheTrainingCenterCoordinator
(must be legible)
ACLS InstructorACLS Instructors teach the ACLS Provider Course.
90-1804 3/11This card contains unique security features to protect against forgery.
PEELHERE
This card certifies that the above individual is an American Heart Association Advanced Cardiovascular Life Support (ACLS) Instructor.
Issue Date Expiration Date
A C L S I N S T R U C T O R
ACLSInstructor
A C L S I N S T R U C T O RTC TC ID #Alignment
TC TCAddress Phone
TCCity, State ZIP
InstructorID #
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1804
Quality Control Checkpoints
IssuedatebeginningMay 10, 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescards70-2909and70-2921
Associated Materials for Instructors
AdvancedCardiovascularLifeSupportInstructorManual AdvancedCardiovascularLifeSupportProviderManual 2010HandbookofEmergencyCardiovascularCare forHealthcareProviders
Quality Control Checkpoints
IssuedatebeginningMarch 5, 2001 CarddesignvalidthroughJune30,2013 Not valid for issue after June 30, 2011, and is
superseded by cards 90-1803 and 90-1804 Expirationdate2yearsfrommonthofissue
Associated Materials for Instructors
AdvancedCardiovascularLifeSupportInstructorManual AdvancedCardiovascularLifeSupportProviderManual HandbookofEmergencyCardiovascularCare forHealthcareProviders
ACLSResourceTextforInstructorsand ExperiencedProviders
90-1804 3-card 90-1803 2-card self-mailer
TCF certificate and card printed by Training Center Coordinator using template available on AHA Instructor Network
70-2921 R12/08
Training CenterAlignment
TC AddressContact Info
CourseLocation
TCCoordinator
HoldersSignature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2921
ACLS Instructor
This card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the American Heart Association for the Advanced Cardiovascular Life Support Instructor Program.
Issue Date Expiration Date
70-2921 3-card 70-2909 2-card self-mailer
ACLS Training Center Faculty
has been appointed as an Advanced Cardiovascular Life Support Training Center Faculty
for the American Heart Association.
TC Name TC Coordinator
Term RegionKJ0835 ACLS 6/10
ACLS
17
ACLS ProviderThe ACLS Provider Course is designed to teach providers the knowledge and skills needed to evaluate and
manage cardiovascular emergencies, stroke, and respiratory arrest.
Quality Control Checkpoints
IssuedatebeginningMay 10, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards70-2908and70-2920
Quality Control Checkpoints
IssuedatebeginningMay 2001 ValidthroughJune30,2013 Not valid for issue after June 30, 2011, and is
superseded by cards 90-1805 and 90-1806 Renewaldate2yearsfrommonthofissue
ACLS EP InstructorACLS Experienced Provider (EP) Instructors teach the ACLS Experienced Provider Course.
70-2920 R1/08
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2920
ACLS Provider
This card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the American Heart Association for the Advanced Cardiovascular Life Support Program.
Issue Date Recommended Renewal Date
Quality Control Checkpoints
IssuedatebeginningMarch 5, 2001 Validuntilfurthernotice Expirationdate2yearsfrommonthofissue
70-2920 3-card 70-2908 2-card self-mailer
90-1806 3-card 90-1805 2-card self-mailer
70-2923 12/00
AHARegion
CommunityTraining Center
TrainingSite
Instructor
HoldersSignature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2923
ACLS EP InstructorThis card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the American Heart Association for the ACLS Experienced Provider Instructor Program.
Issue Date Expiration Date
70-2923 3-card
90-1806 3/11This card contains unique security features to protect against forgery.
PEELHERE
ACLSProvider
This card certifies that the above individual has successfully completed the cognitive and skills evaluations in accordance with the curriculum of the American Heart Association Advanced Cardiovascular Life Support (ACLS) Program.
Issue Date Recommended Renewal Date
ADVANCED CARDIOVASCULAR LIFE SUPPORT ADVANCED CARDIOVASCULAR LIFE SUPPORT
Training TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1806
ACLSACLS Experienced ProviderThe ACLS Experienced Provider Course is designed for seasoned ACLS providers who wish to renew their
provider status. The course provides a stimulus for expert clinicians and scientists to identify and discuss
resuscitation in special circumstances.
Quality Control Checkpoints
IssuedatebeginningMarch 5, 2001 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue
70-2922 R3/09
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2922
This card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the American Heart Association for the ACLS Experienced Provider Program.
Issue Date Recommended Renewal Date
ACLS Experienced Provider
70-2922 3-card
18
PALS and PEARS
PALS and PEARS(Pediatric Advanced Life Support and Pediatric Emergency Assessment, Recognition, and Stabilization)
PALS National FacultyPALS National Faculty (NF) members are PALS Instructors appointed by their respective National ECC
Committees. PALS NF members are responsible for quality assurance and are the educational leadership
forthePALSProgramwithintheirregionsinstructornetwork.NFmembersarekeyresourcesfortheRegionalECC Committee. The NF status is not transferable between regions or states. This card is not an acceptable
substitute for an instructor card and does not verify instructor status dates.
Quality Control Checkpoints
IssuedatebeginningJuly 2007 Termofappointment Carddesignvaliduntilfurthernotice
Back of Card
AHAECCmissionstatement SignatureofappointedNFmember(inink)
PALS National Faculty
John DoeTerm: July 2011 June 2012
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
John Doehas been appointed as a Pediatric Advanced Life Support National
Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe PROAD Chair
PALS NationalFaculty
PALS National Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as a Pediatric Advanced Life Support National
Faculty for the American Heart Association XXXXXX Region .
Term: July 2011 June 2012Jane Doe PROAD Chair
PALS NationalFaculty
PALS National Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as a Pediatric Advanced Life Support National
Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe PROAD Chair
PALS NationalFaculty
KJ0462
R4/10
KJ0462
R4/10
KJ0462
R4/10
PALS Regional FacultyPALS Regional Faculty (RF) members are PALS Instructors appointed by their respective Regional ECC
Committees. PALS RF members are responsible for quality assurance and are the educational leadership
forthePALSProgramwithintheirregionsinstructornetwork.RFmembersarekeyresourcesfortheregionsTraining Centers. The RF status is not transferable between regions or states. This card is not an acceptable
substitute for an instructor card and does not verify instructor status dates.
PALS Regional Faculty
John DoeTerm: July 2011 June 2012
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
Natio
nal Center
EC
C P
rograms
7272 Greenville A
ve.D
allas, TX 75231-4596
John Doehas been appointed as a Pediatric Advanced Life Support Regional
Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair
PALS RegionalFaculty
PALS Regional Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as a Pediatric Advanced Life Support Regional
Faculty for the American Heart Association XXXXXX Region .
Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair
PALS RegionalFaculty
PALS Regional Faculty
John DoeTerm: July 2011 June 2012
John Doehas been appointed as a Pediatric Advanced Life Support Regional
Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair
PALS RegionalFaculty
KJ0562
R4/10
KJ0562
R4/10
KJ0562
R4/10
Quality Control Checkpoints
IssuedatebeginningJuly 2007 Carddesignvaliduntilfurthernotice Termofappointment
Back of Card
AHAECCmissionstatement SignatureofappointedRFmember(inink)
19
National Faculty cards produced and distributed by AHA National Center
Regional Faculty cards produced and distributed by AHA National Center
PALS and PEARS
20
PALS Training Center FacultyPALS Training Center Faculty (TCF) members are appointed by their respective Training Centers. PALS TCF
members are responsible for quality assurance and are the educational leadership for all PALS courses
within their Training Center network. TCF members conduct instructor courses, monitor new and renewing
instructors,andconductupdatesfortheTrainingCentersinstructors.Thiscardisnotanacceptablesubstitutefor an instructor card and does not verify instructor status dates.
Quality Control Checkpoints
IssuedatesbeginningJune 30, 2010 Carddesignvaliduntilfurthernotice NameoftheappointingTrainingCenter Monthandyearofappointment Dateforreappointment(monthandyear) TrainingCenteralignment TrainingCenteraddressandcontactinformation FirstandlastnameoftheTrainingCenterCoordinator
(must be legible)
PALS InstructorPALS Instructors teach the PALS Provider Course and the PEARS Provider Course.
90-1817 3/11This card contains unique security features to protect against forgery.
PEELHERE
TC TC ID #Alignment
TC TCAddress Phone
TCCity, State ZIP
InstructorID #
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1817
This card certifies that the above individual is an American Heart Association Pediatric Advanced Life Support (PALS) Instructor.
Issue Date Expiration Date
P A L S I N S T R U C T O R
PALS Instructor
P A L S I N S T R U C T O R Quality Control Checkpoints
IssuedatebeginningOctober 12, 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescard70-2919
Associated Materials for Instructors
PediatricAdvancedLifeSupportInstructorManual PediatricAdvancedLifeSupportProviderManual PediatricEmergencyAssessment,Recognition, andStabilizationInstructorManual
PediatricEmergencyAssessment,Recognition, andStabilizationProviderManual
2010HandbookofEmergencyCardiovascularCare forHealthcareProviders
90-1817 3-card
TCF certificate and card printed by Training Center Coordinator using template available on AHA Instructor Network
PALS Training Center Faculty
has been appointed as a Pediatric Advanced Life Support Training Center Faculty
for the American Heart Association.
TC Name TC Coordinator
Term RegionKJ0835 PALS 6/10
PALS and PEARS
21
PALS ProviderThe PALS Provider Course teaches students how to recognize infants and children at risk of cardiopulmonary
arrest, provides students with strategies for preventing cardiopulmonary arrest in infants and children, and
teaches how to perform the cognitive and psychomotor skills for resuscitating and stabilizing infants and
children in respiratory failure, shock, or cardiopulmonary arrest.
Quality Control Checkpoints
IssuedatebeginningOctober 12, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards70-2906and70-2918
Quality Control Checkpoints
IssuedatebeginningJanuary 21, 2002 ValidthroughDecember31,2013 Not valid for issue after December 31, 2011, and
is superseded by cards 90-1808 and 90-1818 Renewaldate2yearsfrommonthofissue
70-2918 R1/08
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2918
PALS Provider
This card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the American Heart Association for the Pediatric Advanced Life Support Program.
Issue Date Recommended Renewal Date
70-2918 3-card 70-2906 2-card self-mailer
90-1818 3-card 90-1808 2-card self-mailer
90-1818 3/11This card contains unique security features to protect against forgery.
PEELHERE
PALS Prov ider
This card certifies that the above individual has successfully completed the cognitive and skills evaluations in accordance with the curriculum of the American Heart Association Pediatric Advanced Life Support (PALS) Program.
Issue Date Recommended Renewal Date
P E D I AT R I C A D VA N C E D L I F E S U P P O R T P E D I AT R I C A D VA N C E D L I F E S U P P O R T
Training TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1818
Quality Control Checkpoints
IssuedatebeginningJanuary 21, 2002 CarddesignvalidthroughDecember31,2013 Not valid for issue after December 31, 2011, and
is superseded by card 90-1817 Expirationdate2yearsfrommonthofissue
Associated Materials for Instructors
PediatricAdvancedLifeSupportInstructorManual PediatricAdvancedLifeSupportProviderManual PediatricAdvancedLifeSupportCourseGuide PediatricEmergencyAssessment,Recognition, andStabilizationInstructorManual
PediatricEmergencyAssessment,Recognition, andStabilizationProviderManual
HandbookofEmergencyCardiovascularCare forHealthcareProviders
70-2919 R1/08
Training CenterAlignment
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2919
PALS Instructor
This card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the American Heart Association for the Pediatric Advanced Life Support Instructor Program.
Issue Date Expiration Date
70-2919 3-card
Quality Control Checkpoints
IssuedatebeginningNovember 29, 2007 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Uponrelease,willbesupersededbycard90-1819
80-1215 8/07
TrainingCenter
TC AddressContact Info
CourseLocation
Instructor
HoldersSignature
2007 American Heart Association Tampering with this card will alter its appearance. 80-1215
PEARS Provider
This card certifies that the above individual has successfully completed the objectives and skills evaluations in accordance with the curriculum of the American Heart Association Pediatric Emergency Assessment, Recognition, and Stabilization Course.
Issue Date Recommended Renewal Date
PEELHERE
This card contains unique security features to protect against forgery.80-1215 3-card
PALS and PEARS
22
PEARS ProviderThe PEARS Provider Course is designed to help the basic pediatric healthcare provider develop the knowledge
and skills for emergency assessment and treatment of seriously ill infants and children.
Quality Control Checkpoints
Issuedate:tobereleasedSpring 2012 Uponrelease,validuntilfurthernotice Renewaldate2yearsfrommonthofissue Uponrelease,thiscardsupersedescard80-1215
90-1819 3/11This card contains unique security features to protect against forgery.
PEELHERE
PEARS Prov ider
This card certifies that the above individual has successfully completed the cognitive and skills evaluations in accordance with the curriculum of the American Heart Association Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS) Program.
Issue Date Recommended Renewal Date
P E A R S P R O V I D E R P E A R S P R O V I D E RTraining TC ID #Center Name
TC TCInfo City, State ZIP Phone
CourseLocation
Instructor Inst. ID #Name
HoldersSignature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1819
90-1819 3-card
Course Card Index
Course Card Index
Below is a comprehensive list of course cards with product numbers, including 2 different formats for the
cards: 3-card sheet and 2-card sheet, self-mailer. For cards that list 70-, 80-, and 90- product numbers, the
90- product number reflects the most current version.
Only current American Heart Association Training Centers may order course cards.
Card Description
Current Version of Card Earlier Version of Card
3-Card Sheet2-Card Sheet,
Self-Mailer3-Card Sheet
2-Card Sheet,Self-Mailer
BLS
BLS Instructor 90-1800 90-1807 70-2916 70-2904
BLS Healthcare Provider 90-1801 90-1802 70-2915 70-2903
Heartsaver
Heartsaver Instructor 90-1816 80-1205
Heartsaver Skills Evaluator 90-1822 80-1216
Heartsaver First Aid Instructor Discontinued Discontinued 70-2965 70-2964
Heartsaver CPR AED 90-1813 90-1810 80-1203 80-1211
Heartsaver CPR Discontinued Discontinued 80-1204 80-1210
Heartsaver AED Discontinued Discontinued 80-1203 80-1211
Heartsaver First Aid 90-1814 90-1809 80-1202 80-1208
Heartsaver First Aid CPR AED 90-1815 90-1820 80-1202 80-1208
Heartsaver Pediatric First Aid 80-1201 80-1209
Heartsaver CPR AED in Schools 90-1821 80-1200
Heartsaver CPR in Schools 80-1200
ACLS
ACLS Instructor 90-1804 90-1803 70-2921 70-2909
ACLS Provider 90-1806 90-1805 70-2920 70-2908
ACLS EP Instructor 70-2923
ACLS Experienced Provider 70-2922
PALS and PEARS
PALS Instructor 90-1817 70-2919
PALS Provider 90-1818 90-1808 70-2918 70-2906
PEARS Provider 90-1819 80-1215
23
ECCTo order, contact one of the following:
C H A N N I N G B E T E C O M P A N Y
One Community Place | South Deerfield, MA 01373-0200
P H O N E : 800-611-6083 | F A X : 800-499-6464aha.channing-bete.com
L A E R D A L M E D I C A L C O R P O R A T I O N
167 Myers Corners Road | Wappingers Falls, NY 12590-8840
P H O N E : 888-562-4242 | F A X : 800-227-1143 laerdal.com
W O R L D P O I N T E C C , I N C .
1326 S. Wolf Road | Wheeling, IL 60090
P H O N E : 888-322-8350 | F A X : 888-281-2627eworldpoint.com
For more information on other American
Heart Association programs contact us:
877-AHA-4CPR
www.heart.org/cpr
7272 Greenville AvenueDallas, Texas 75231-4596
www.heart.orgKJ0916 9/11