Instructor Course

Advanced Cardiac Life

Directions:

The purpose of the ACLS Instructor course is to

train new ACLS Instructors.
New Instructor Candidates are required to have
current ACLS credentials good for more than
ninety days after date of instructor course and
have comprehensive experience in Advanced Cardiac Life Support subject matter. The course will
focus on facilitation techniques.

Take the James Street exit off I-5 in the downtown area of
Seattle. Turn up the hill (east) on James Street. (Left from I-5 S
and Right from I-5 N) Turn right (south) on Ninth Avenue
and go two blocks. Harborviews Research & Training Building is on the corner of Ninth Avenue and Alder Street.

Parking:
Parking is extremely limited. Visitor parking in View Park parking garage
is available. Allow at least thirty minutes to find a parking space.

WE DO NOT VALIDATE PARKING

Other parking options near Harborview are:

The Core Instructor Course needs to be completed prior to instructor card issued.

Republic Parking 206-783-4144, Broadway & Madison.

U-Park 206-652-4185, 6th Ave. & Washington St.
Merchants Parking 206-624-3426, 7th Ave. & Yesler Wy.
CPS Parking, 6th Ave. & Yesler, 7th Ave. & Columbia St.

2010 Course Dates & Times

Bus Service:

March 20 [Saturday
June 10 [Friday]
November 5 [Friday]

Metro provides regular bus service to Harborview on several

routes, including 3, 4, 60, and 205. Routes 941, 942, and 943
provide express bus service from the north, east, and south
during peak hours. To find the best routes from your bus stop,
call Metro (206-553-3000) or browse King County Metro
Online (www.transit.metrokc.gov) for schedules.

Registration fifteen minutes before class

Lunch on your own.

Terry Avenue

Course Materials Included

Maleng

ACLS Instructor Manual

ACLS Provider Manual
Core Instructor Course

Certification Prerequisites
The following prerequisites must be met:

ACLS Provider for at least two years.

Proficient in ACLS and BLS skills.

Jefferson Street

Included materials:

Building
|

Harborview
Hall
Ninth Avenue
Harborview Medical Center

S
W

R&T
Building
|

Alder Street

0800-1700
0800-1700
0800-1700

2010
ACLS
Instructor

Harborview Community Training Center

Location: 300 Ninth Ave s Seattle, WA 98104
Mail: 325 Ninth Avenue Box 359733 Seattle, WA 98104
Phone: (206) 744-5027 Fax: (206) 744-2043
hmcctc@u.washington.edu

Presented By Harborview
Community Training Center

ACLS Instructor Info:

Criteria for Completion:

Successfully perform the skills listed in the Critical

Actions Checklist.

Successfully display an understanding of the cognitive content of the Critical Actions Checklist.

Successfully evaluate other participants in the CPR-D

section.

Registration Requirement:
Pre-Registration Requirements:

The following items must be submitted before you can be considered

and registered for the course:

Completed ACLS Instructor Candidate Form (please call to

request).

Optional Text

This registration form and payment in full (see below for registration information).
Copy of current ACLS Provider card must accompany registration. ACLS Provider card must remain current for ninety days
after date of Instructor Course.

Demonstrate interpersonal communication and management skills and abilities appropriate for adult education and professional education.

Class Times:

After the initial monitoring session has been finished,

send or drop off completed paperwork (Dataform,
Responsibilities Agreement, and Monitor Form) to
Harborview Community Training .
New Instructors must agree to abide by Harborview
Community Training Center & American Heart Association Guidelines.

ACLS Instructor
ACLS Instructor

Obtain at least a 90% score on the ACLS Provider

Examination at the end of the class.

Within ninety days of taking the ACLS Instructor

Course arrange to be monitored by an American
Heart Association ACLS Training Center Faculty
member while teaching an ACLS station during an
ACLS class.

Date of Course: ________________________________

Letter of recommendation from current ACLS Instructor or

AHA Regional Faculty member which includes their contact
information.

2010 ACLS Instructor:

Part 1: In-class Course

Part 1

0800 1700

Part 2: Online: Core Instructor Course

Part 2* 0800 1630
*You may take home and complete on your own time or use
classroom time to complete

Fees:

$325 (Includes Text)

To Register:
Registration and fee must be received at least
three weeks prior to course date.
You can register by doing one of the following:

A letter from Training Center or a reference to confirm you as a suitable candidate for instructing

$325

Other Participant /UW Staff Includes Texts*

Harborview Employee: Please fill out
C.E. request form

$20

ECC Handbook (Updated 2008)

** Includes ACLS Instructor Manual and ACLS Provider Manual.

Total Cost: _____________ (Fee is non-refundable)

Name

Circle one: MD RN PA MA EMT/PM DDS

Organization/Unit

Box Number

Address (to receive study material)

City, State, Zip

Phone - Area Code

Email

Method of Payment:
Check* ______________
PO #________________
Credit Card Number

*Make Payable to HMC CTC

UW Budget
(See Box Below)
Visa/MasterCard
American Express

Register online
http://depts.washington.edu/hmcpcs/ctc/

CSV

The 3 digit number printed on the back of your card.

Exp. Date _____/_____

Fax to 206-744-2043
Signature

Late registrations will be negotiated on a spaceavailable basis only.

Registration fees are NON-REFUNDABLE.

AHA Fee Disclaimer:

Use of materials for education in this American Heart Association
credentialing course does not represent income to the Association.

We can process a class reschedule ONE TIME

ONLY. After that you will have to register again.

UW Staff:

Charge Budget

PLEASE PRINT

Budget Name: ________________________________________

Budget #__________________ Box #___________________
Managers Name: ________________________________
Managers Signature: _____________________________
HMC PCS STAFF: Before you can register for a class, you must submit
your signed and approved CER request form to Clinical Education 9EH49 Box 359733. Please call 206-744-6396 if you have any questions.