ACLS EXPERIENCED PROVIDER COURSE
Offered by Health Education Strategies, LLC
The American Heart Association ACLS-EP is a stimulating new course offered as an alternative to the traditional ACLS renewal course. The goal
of the ACLS EP Course is to improve outcomes in complex cardiovascular, respiratory and other (e.g., metabolic, toxicologic) emergencies by
expanding on core ACLS guidelines and encouraging critical thinking and decision-making strategies.
This course is for seasoned healthcare providers who are proficient in performing BLS and ACLS skills, reading and interpreting ECGs, and
understanding ACLS pharmacology and who regularly lead or participate in emergency assessment and treatment of prearrest, arrest or post
arrest patients.
PREREQUISITE: The ACLS-EP Course is open to persons who meet the following criteria:
1.) Are healthcare professionals who, based on their occupations, have a duty to respond to any need for resuscitation efforts.
2.) Have documentation of successful completion of an AHA ACLS provider course within the previous two years; OR
3.) ACLS knowledge must be updated to AHA Guidelines 2010.
4.) Possess a current AHA ACLS & AHA BLS Healthcare Provider card. (Include copies of cards with registration and payment)
COURSE FEE: $265.00. Fee includes all course materials. Materials will be distributed upon receipt of payment.
****Prior to attending this course, you must complete the ACLS EP Exam Key (90-1083) and bring a copy of your completion certificate
with you on arrival for the course.**** (This key will be sent to you from our office via email.)****
REGISTRATION DEADLINE: Two (2) weeks prior to course date. Registrations received after the deadline will be subject to an additional $10.00
late registration fee.
COURSE LOCATION: Health Education Strategies, LLC, 9095 Allen Road, Allen Park, MI 48101. A Map will be emailed to you.
CANCELLATION POLICY: Fees are NON-REFUNDABLE but may be applied to a future rescheduled course if taken within six (6) months of the
cancelled course. Cancellations made within two weeks of the course will be charged an additional $75.00 rescheduling fee.
ACLS EP/BLS-HCP REGISTRATION FORM
(Please check course date you are registering for and if you require BLS-HCP training)
Office Use Only
ACLS-EP - $265
8:00am – 4:30pm
BLS-HCP TRAINING-$60
 YES
 NO
Amt Pd: $_______________
(Include copy of current AHA ACLS card
with registration and payment)
(If NO, include copy of current AHA BLS-HCP
card with registration and payment)
 Check  Money Order
 July 25, 2015
 August 29, 2015
 September 26, 2015
 October 24, 2015
 November 21, 2015
 December 12, 2015
PLEASE PRINT CLEARLY: H.E.S. is not responsible for lost mail.
Name: ______________________________________________________________________________
 Credit Card  Cash
#______________________
Date: __________________
Rec’d: _________________
ADD
Late Registration
Fee - $10.00
Yes
Credentials/Title: ___________________ E-mail Address: _____________________________________
Day Telephone: __________________________ Night Telephone: ______________________________
Home Mailing Address: _________________________________________________________________
(U.S. Mailing Address Only)
City, State, Zip Code: ___________________________________________________________________
Employer: _____________________________________ Department: ___________________________
PAYMENT MUST ACCOMPANY REGISTRATION
Please make check/money order payable to “Health Education Strategies, LLC” and mail to:
9900 Allen Road, Allen Park, MI 48101 (Canadian checks must be US Currency).
For further Information, Contact: Marilyn Enriquez at 313-388-7772/Fax: 313-388-2219
Email: healthedst@aol.com Web: www.healtheducationstrategies.com
WE ACCEPT VISA/MASTERCARD/DISCOVER CREDIT CARD PAYMENTS
Card Number:
Expiration (Month/Year):
Total Amount:
Cardholder Name:
Cardholder Billing Address:
Office Use Only
Materials Provided:
 ACLS EP Manual & Resource
Text (90-1075)
 ACLS EP Exam Key
Date Issued: ________________
 BLS-HCP Manual (90-1038)
 Letter w/Agenda/Map
 Receipt
 Mailed  Picked Up
Date: ______________________
I agree to pay above amount according to card issuer agreement
Cardholder Signature:
The American Heart Association strongly promotes knowledge and proficiency in BLS, ACLS, and PALS 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. Any fees charged for such a course, except for a portion of fees needed for AHA course materials; do
not represent income to the Association. Updated 10/30/14