PALS, PEARS, ACLS, and BLS "*" indicates required fields Hiddenprogram name Which 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 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. January 7 & 8, 2025 February 5 & 6, 2025 February 25 & 26, 2025 March 10 & 11, 2025 March 26 & 27, 2025 Training Dates - PALS Update Course*Please choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. TEXTBOOKS: For Update courses only, BCH employees are offered the use of a manual from our library system up to 1 month in advance of your scheduled course date. To borrow a manual please contact the office x52649. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* November 25, 2024 November 26, 2024 December 2, 2024 December 6, 2024 December 17, 2024 December 20, 2024 January 6, 2025 January 15, 2025 Waltham January 28, 2025 January 29, 2025 February 4, 2025 February 10, 2025 February 12, 2025 February 19, 2025 Waltham March 6, 2025 March 12, 2025 March 19, 2025 Waltham March 25, 2025 PEARS ProviderPlease choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. . *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* November 18, 2024 January 9, 2025 January 27, 2025 February 3, 2025 February 11, 2025 March 13, 2025 March 31, 2025 Select AllPEARS UpdateTHIS COURSE DOES NOT EXIST. Please use the PEARS Provider form only. This is not a course currently available at BCH. Select AllTraining Dates- ACLS Provider Course*Please choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* January 22 & 23, 2025 March 3 & 4, 2025 Training Dates - ACLS Update Course*Please choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. TEXTBOOKS: For Update courses only, BCH employees are offered the use of a manual from our library system up to 1 month in advance of your scheduled course date. To borrow a manual please contact the office x52649. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* October 17, 2024- Waltham November 21, 2024 - Waltham December 16, 2024 December 19, 2024 - Waltham January 16, 2025 Waltham January 21, 2025 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 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. TEXTBOOKS: For Update courses only, BCH employees are offered the use of a manual from our library system up to 1 month in advance of your scheduled course date. To borrow a manual please contact the office x52649. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* First Choice Second Choice Third Choice Training Dates - BLS Waltham*Please choose 3 dates and use the special instruction box to list choices in order. When you only choose 1 date this holds up the process of getting you seated and you may have to fill out a new form. Once confirmed into a course, there is an administration fee for date changes and cancellations. TEXTBOOKS: For Update courses only, BCH employees are offered the use of a manual from our library system up to 1 month in advance of your scheduled course date. To borrow a manual please contact the office x52649. *All courses have sign in from 6:45am-7:00am. You are required to be seated in class no later than 7:00am* 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*You must make sure to use your professional BCH email address, if you have a name change please make sure to use the correct BCH email address. Phone*Home Address (business addresses are not accepted)* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Do you require BLS CPR with your course? (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. Use this section to place class dates in order of choice. Will your department be covering the cost?If you are covering the cost of your course you must call the office at 617-355-26449 ( or ext 52649) to submit payment before we are able to process your request. 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 payment PhoneThis field is for validation purposes and should be left unchanged. Δ