American Heart Association Emergency …€¦ · Web viewAuthor James McNulty Created Date...

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CARE Program Payment Form Parcipant Informaon Full Name: Credenal: Hospital and Department: E-mail Address (required): Registraon Informaon Please select the appropriate course and indicate course date: Course (book materials not included) Fee: Course Date: o PALS Provider class $250 o PALS Renewal class* $150 o PEARS class $150 o ACLS Renewal class* $152 o PALS HeartCode (online) class $210 o ACLS HeartCode (online) class $210 o BLS HeartCode (online) class $46 * Please submit copy of current card o BLS HeartCode Add-on (available for all courses) $46 Payment Informaon o Card payment: Visa/MasterCard accepted. Details provided during registraon confirmaon. o Check payment: Please make checks payable to OHSU CARE. Please send payment to: OHSU CARE Collaborave Life Sciences Building Mailcode: CL4C 2730 SW Moody Ave. Portland, OR 97201 Center for the Advancement of Resuscitation Education [email protected] | 503.346.4425

Transcript of American Heart Association Emergency …€¦ · Web viewAuthor James McNulty Created Date...

Page 1: American Heart Association Emergency …€¦ · Web viewAuthor James McNulty Created Date 04/09/2018 17:18:00 Title American Heart Association Emergency Cardiovascular Care Program

C A R E P r o g r a mP a y m e n t F o r m

Participant Information

Full Name:

Credential:

Hospital and Department:

E-mail Address (required):

Registration InformationPlease select the appropriate course and indicate course date:

Course (book materials not included) Fee: Course Date:

o PALS Provider class $250

o PALS Renewal class* $150

o PEARS class $150

o ACLS Renewal class* $152

o PALS HeartCode (online) class $210

o ACLS HeartCode (online) class $210

o BLS HeartCode (online) class $46

* Please submit copy of current card

o BLS HeartCode Add-on (available for all courses) $46

Payment Information

o Card payment: Visa/MasterCard accepted. Details provided during registration confirmation. o Check payment: Please make checks payable to OHSU CARE.

Please send payment to:

OHSU CARECollaborative Life Sciences BuildingMailcode: CL4C2730 SW Moody Ave.Portland, OR 97201

Center for the Advancement of Resuscitation [email protected] | 503.346.4425