PALS, PEARS, ACLS, and BLS "*" indicates required fields This field is hidden when viewing the formprogram nameWhich training would you like to attend*NOTE: It is the sole responsibility of every participant to add only dates they know they are available to attend. We suggest you review our cancellation policy. Without a 21 business day cancellation there is no refund. Prior to 21 business days if you request a date change there is a $25.00 fee payable by the participant at time of request. A date change request less than 21 business days, the participant is responsible for the full course fee. Please remember you should hear back from this program by email within 48 business hours following submission with either a course confirmation or request for missing information. If you do not hear back you should contact the office 617-355-2649. Pediatric Advanced Life Support (PALS) Pediatric Emergency Assessment, Recognition and Stabilization (PEARS) Advanced Cardiovascular Life Support (ACLS) PALS Provider Course or Update Course**All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* Provider Course Update Course PEARS Provider Course or Update Course**All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* Provider Course Update Course ACLS Provider Course or Update Course**All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* Provider Course Update Course Training Dates - PALS Provider Course*Please choose more than 1 date that you know you can attend when available. Choosing more than 1 course date helps us to serve you without delay. All 1st quarter 2025 PALS Provider course dates have filled to capacity. Please watch this form for the release of our 2nd quarter dates in early January 2025. Training Dates - PALS Update Course*Please choose 3 dates that you know you can attend when available. Choosing more than 1 course date helps us to serve you without delay. January 29, 2025 February 4, 2025 February 12, 2025 (1 seat) March 25, 2025 PEARS ProviderPlease choose 3 dates that you know you can attend when available. Choosing more than 1 course date helps us to serve you without delay. December 19, 2024- Waltham Select AllPlace HolderTHIS COURSE DOES NOT EXIST. This is not a course currently available at BCH. Select AllTraining Dates- ACLS Provider Course*Please choose 3 dates that you know you can attend when available. Choosing more than 1 course date helps us to serve you without delay. All 1st quarter 2025 ACLS Provider course dates have filled to capacity. Please watch this form for the release of our 2nd quarter dates in early January 2025. Training Dates - ACLS Update Course*Please choose 3 dates that you know you can attend when available. Choosing more than 1 course date helps us to serve you without delay. January 16, 2025 Waltham February 20, 2025 Waltham February 27, 2025 March 5, 2025 March 20, 2025 Waltham Course Location*At which facility will you be taking the BLS course? Boston Waltham Training Dates - BLS Boston*Please choose more than 1 date that you know you can attend when available. Choosing more than 1 course date helps us to serve you without delay. First Choice Second Choice Third Choice Training Dates - BLS Waltham*Please choose more than 1 date that you know you can attend when available. Choosing more than 1 course date helps us to serve you without delay. First Choice Second Choice Third Choice Upload a copy of your current Certification Card (only if you did not take your last course @BCH)Max. file size: 64 MB.Name*As you would like it to appear on card First Last RN, MD, PNP, Other:*Are you a Boston Children's employee or affiliate?* Yes No Status (employees only)* Full time Part time (covered by dept of nursing if you have a reg 20hr. schedule) Per diem (not covered by dept of nursing) Travel (not covered by dept of nursing) Email*This office will only respond to your professional BCH email address, if you have had a recent name change please make sure to use the correct BCH email address. 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(To add post submission there is $25.00 admin fee)*We strongly encourage anyone who requires BLS to add it to an advanced course. This will leave you with 1 less credential to remember updating. Yes No BCH Employee ID #*Department name*Special Instructions. This is a free text field.Will your department be covering the cost?If you are a Per Diem, travel, or a Part time nurse working less than 20 hrs. a week you must cover the cost of your course. To submit payment please call the office at 617-355-26449 (or ext. 52649). We are unable to seat you until payment has been secured. Yes No Payment - Department ID# and Approving Managers name*Not required for RNs/APNs (your dept. ID is on file). For others (MDs, PAs, RRT, etc.), we are unable to process without numerical number and approver name.PaymentFor security purposes; before registration can be processed self-paying participants must contact the office 617-355-2649 during normal business hours Monday through Friday 7:00am- 3:30pm to make paymentCommentsThis field is for validation purposes and should be left unchanged. Δ