Who are you registering?* must provide value
Yourself
Someone Else
Your Group
Are you requesting a specific date/time for your group? Course requests are subject to instructor availability, and require a minimum of 6 students. Yes
No
Student Info will be collected below. What is your name?* must provide value
Name of person completing form
Student Info will be collected below. What is your email address?* must provide value
Email of person completing form
Student Info will be collected below. What is your phone number?* must provide value
Phone number of person completing form
Would you like to register for a provider course or an instructor course?* must provide value
Provider Course
Instructor Course (none currently scheduled)
Would you like to register for an Instructor-Led course, or a HeartCode ("Online") course followed by an In-Person Skills Assessment.* must provide value
Instructor-Led Course Renewal Course (ACLS Only at this time)
Online Course with Skills Assessment
What's the Difference?
Online Courses require in-person skills assessments.
Students who take an "Online Course" will be given access to AHA's HeartCode course. Even though the content of the course is online, students will still need to attend an in-person skills assessment for certification.
The skills assessment will take much less time than a full instructor-led course. However, the Instructor Led Course, requires less prep time, as most of the course content will be delivered in person.
Fees are higher for online courses. Instructor-led courses are scheduled much less frequently. All AHA HeartCode ("online") courses have two parts: The online didactic portion with simulation, and the in-person skills assessment. You must complete both parts in order to have certification. EMSC can provide either or both parts. Choose which part you would like purchase:* must provide value
Both parts (Usual Option)
Skill Assessment Only (I have already completed an AHA HeartCode course)
Access to Online Portion Only (I will find an instructor to complete my skills assessment elsewhere.)
Some Depts provide the online course to employees. Some Depts have in-house instructors who can complete the skills assessment. Please check with your Dept before signing up.
For which online course are you registering?* must provide value
BLS - Basic Life Support
ACLS - with or without BLS
PALS - with or without BLS
ACLS=Advanced Cardiovascular Life Support; PALS = Pediatric Advanced Life Support
For which instructor-led course are you registering?* must provide value
BLS - Basic Life Support (none currently scheduled)
ACLS - with or without BLS
PALS - with or without BLS (none currently scheduled)
ACLS=Advanced Cardiovascular Life Support; PALS = Pediatric Advanced Life Support
For which instructor course are you registering?* must provide value
BLS - None Scheduled
ACLS - None Scheduled
PALS - None Scheduled
BLS-Basic Life Support; ACLS=Advanced Cardiovascular Life Support; PALS = Pediatric Advanced Life Support
Would you like to renew your BLS certification at the same time?* must provide value
No - I am current in BLS.
Yes - I plan to renew BLS certification at the same time.
I'm not sure. What would this involve?
If you would like to complete/renew your BLS certification at the same time as your ACLS or PALS course, you will be sent an email with instructions for completing the BLS HeartCode course online. At the beginning or end of your PALS or ACLS course/skills assessment, you will have a BLS skills assessment to complete this renewal. BLS Online - Skills Date* must provide value
Feb. 19, 2021 - 12:30pm
Mar. 19, 2021 - 12:30pm
Apr. 16, 2021 - 12:30pm
May 21, 2021 - 12:30pm
Jun. 18, 2021 - 12:30pm
ACLS Online - Skills Date* must provide value
Feb. 19, 2021 - 2:00pm
Mar. 19, 2021 - 2:00pm
Apr. 16, 2021 - 2:00pm
May 21, 2021 - 2:00pm
Jun. 18, 2021 - 2:00pm
PALS Online Course Date* must provide value
Feb. 19, 2021 - 10:00am
Mar. 19, 2021 - 10:00am
Apr. 16, 2021 - 10:00am
May 21, 2021 - 10:00am
Jun. 18, 2021 - 10:00am
BLS Instructor-Led Renewal Course* must provide value
No Dates are currently available.
ACLS Instructor-Led Renewal Course* must provide value
2/22/2021 - 2/23/2021 (08:30-17:00) - Initial Course
PALS Instructor-Led Renewal Course* must provide value
No Dates are currently available.
What dates/times would you like to have this course?* must provide value
Do you already know who will be in the class (i.e. can you upload your student list now)?* must provide value
Yes
No
Please use this template to provide your students' information. Please upload the spreadsheet with your students' information.* must provide value
If you do not have a complete list of students available yet, you can email your list later. However, please let us know approximately how many students you plan to have.* must provide value
First Name* must provide value
Name you would like on your certification
Last Name* must provide value
Name you would like on your certification
Email Address* must provide value
Your certification will be tied to this email address. Do not use a shared address.
Phone Number* must provide value
Used only for last minute communication, such as cancellation for weather.
Affiliation:* must provide value
Please include OUHSC Dept, if applicable
Profession:* must provide value
Physician
Medical Student
PA
RN
EMT
Paramedic
LPN
Other
If you marked profession as other, please specify:* must provide value
Our fee schedule is attached. OUHSC employees and other affiliates may request that their Department/Employer be billed. How do you plan to make payment?* must provide value
I will mail a Check
I will pay online with a Credit Card
Bill my Department (OUHSC Only)
Bill my Employer (non-OUHSC)
For Check, please make checks payable to OUHSC. Mail or deliver payment to:
OU Health Science Center - EMSC
940 NE 13th St. 2G-2300
OKC, OK 73104
No course materials will be provided until the check is received.
To pay online, you must go to our online store. This link will open a new tab:
www.oumedicine.com/emscstore
Once you have paid, return to complete your registration. Confirm that you have already paid for your course online by entering your order number. This would have been sent to you in an email.* must provide value
What OUHSC Department is paying for your training?* must provide value
What is the first and last name of your Billing Contact Person?* must provide value
What is the email address of your Billing Contact Person?* must provide value
What is the phone number of your Billing Contact Person?* must provide value
What is the title of your Billing Contact Person?* must provide value
What is the street address of your Billing Contact Person?* must provide value
What is the City, State, and Zip Code of your Billing Contact Person?* must provide value
Course Cancellation Policy - Cancellation must be sent via email to emsc@ouhsc.edu. No fees will be charged for cancellation received within 5 business days prior to the course date/skills appointment. For online courses, if the key has been activated, a charge of $160 will be assessed. It is the Participant's responsibility to request another skills date & time. Participants who re-schedule 3 consecutive courses will be subject to the entire registration fee. No refunds can be made in the case of a "No Call/No Show".* must provide value
I confirm that I have read and understand the cancellation policy.
Please use this space to let us know anything important or to ask questions.