Instructor Renewal Request Nationwide Training Center: Florida Health Science Consulting Training Center ID: FL20961 You must complete a request form for EACH discipline you are renewing. Instructor First & Last Name (required) AHA 11-digit Instructor Number (required) Your Email (required) Telephone Number (required) Discipline (required) —Please choose an option—HeartsaverBLSACLSPALS When does your instructor certification expire? (required) ______________________________________ Acknowledgements (check boxes): I confirm that I am aligned on the AHA Instructor Network with Florida Health Science Consulting (FL20961) as my Primary Training Center. Professional Behavior: The Program Administration Manual provides specific guidelines regarding code of conduct and conflict of interest for all representatives of the AHA as leaders in the community. Instructors need to comply with these AHA guidelines because they represent the AHA while they are conducting courses. I have reviewed the AHA Conflict of Interest Statement. Link: https://www.heart.org/en/about-us/statements-and-policies/conflict-of-interest-policy I have reviewed the AHA Code of Conduct. Link: https://www.heart.org/en/about-us/statements-and-policies/ethics-policy ______________________________________ Renewal Requirements: I have taught at least four (4) provider courses in the past two (2) years. Refer to your Enrollware portal. (enter class dates below) Every instructor must be monitored the same month their instructor certification expires. I have been successfully monitored by a TC faculty member. My monitoring date was on: Upload a completed Instructor/Training Faculty Renewal Checklist. Please complete Section 1 and 2 in its entirety. See below to download a copy of the renewal checklist. PDF only file (required) Upload a completed, updated instructor candidate application. See below to download a copy of the application. PDF only file (required) ______________________________________ Instructor certification eCards are issued within 5-7 business days (does not include the day you submitted this request) from the time that BOTH paperwork AND payment is received. Please contact the instructor compliance officer, Isiah Washington, by email at iwashington@healthscienceconsulting.com if you have any questions. Renewal Fees: $50.00 for each discipline ______________________________________ Please note our office hours are Monday - Thursday 9:00 a.m. - 5:00 p.m. EST. 24013 Instructor Certification Renewal Payment $50.00 Select options Required Forms to Download: Instructor Renewal Checklist 10_2022DownloadInstructor Candidate Application 10_2022Download