SMI Enrollment Form

ACLS Course Registration Enrollment Form

If you have problems using the form below, please e-mail us your registration request at: [email protected]

Looking to sign up for another type of course? Click a blue button below to access the correct enrollment form.

BLS HCP

Basic Life Support for Health Care Providers - Traditional Classroom

PALS

Pediatric Advanced Life Supprt
and BLS skills sesssions

TNCC & ENPC

Trauma Nurse Core Course - or -
Emergency Nursing Pediatric Course

FAQ

Check here for commonly asked questions and answers

Please fill out the ACLS form below and click the 'Submit Request' button at the bottom

Payment options will appear on the next page. You can also wait for an e-mail from us to see payment options.

Questions: Please check our FAQ page

* Indicates required field

Name *

First

Last

Email - please verify your e-mail is typed correctly *

Course date - please choose from the drop-down menu *

Choose One - click on the type of course you are registering for. NOTE: If signing up for ACLS Provider, ACLS renewal, or ACLS skills we will automatically include the option of adding BLS skills in our reply e-mail to you. *

ACLS Provider ACLS Recertification - non expired AHA card Skills session - ACLS (step 2) following taking Heartcode ACLS step 1 through the AHA

Please enter a phone number where you can be reached, and any additional questions/comments. *

Employer, Location *

Add BLS skills session (step 2) to ACLS *

Yes - I would also like to receive a new BLS card at this ACLS session. I will complete Heartcode BLS step 1 http://www.onlineaha.org/courses prior to the ACLS course.

Submit Request

If you hit the 'Submit' button above and nothing happens please e-mail your registration request to: [email protected]
Include your Name, Course Date, Course Type, Phone number, and Employer name.
Some hospitals and ISP's block outgoing form data...which is becoming more common!

Enrollment requests will be processed M-F 8am-5pm.
If you have any trouble submitting your enrollment please e-mail us: [email protected]

We host the very best instructional courses available, using extremely qualified instructors with a strong focus on retention of the materials presented.
All this in a low stress/student friendly environment we are proud of!
Thank you for placing your trust in us, and we look forward to seeing you!

BLS is a pre-requisite for ACLS and PALS. Contact us if you have any questions.

Promoting superior life saving equipment and education for the good of us all.