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UHCMC Rainbow Babies & Children's Hospital
Ad
vance Trauma Life Support
ATLS
Thank you for registering for the American College of Surgeons ATLS course sponsored by UHCMC Rainbow Babies & Children's Level 1 Adult and Pediatric Trauma Department. All courses are held on the campus of UH Cleveland Medical Center in Cleveland, Ohio. Pre-registration is required 30 days before the course. No exceptions. Please submit the registration form and payment to ensure your reserved space. UH employees have first preference.
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First Name
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Last Name
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Last 4 of Social
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Employer
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Resident
Attending
Fellow
Coordinator's email
Title
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MD
DO
PA
NP
RN
Other
Other
Specialty
General Surgery
Emergency Medicine
Internal Medicine
Anesthesia
Pediatrics
Other
Other
Street Address
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Address Line 2
City
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State
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Alabama
Alaska
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Arkansas
California
Colorado
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Delaware
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Hawaii
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Vermont
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Washington
West Virginia
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Washington DC
Zip Code
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Phone Number
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Email Address
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Have you previously attended an ATLS course?
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Yes
No
2 Day Initial Course/1 Day Refresher
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Attending $850.00
Resident/Fellow $650.00
PE/NP $650.00
Auditor $250.00
Physican Refresher $550.00
PE/NP Refresher $500.00
Course Dates. Refreshers are held on Day 2 of two day course.
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January 19th and 20th (This course is FULL)
April 27th and 28th (This course is FULL)
July 20th and 21st (UHCMC Employees Only. This course is FULL)
September 28th and 29th (This course is FULL)
December 7th and 8th (This course is FULL 7/15/18)
Your place in the course is not confirmed until receipt of a confirmation from Moni James EMS-I, ATLS Coordinator. Class size is limited to 24 participants. Registration is on a first-come, first served basis, with submission of registration and payment. UH employees have first priority.
Name on Card
Credit Card Type
Visa
MasterCard
American Express
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Credit Card Number
cvc
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Expiration Date (mm/yy)
UHCMC Cost Center Number
If credit card information is completed or you are paying by check, hit the continue button below.
Cancellations 31 days or more prior to the course will be subject to a $100.00 administrative fee. No refunds will be issued for cancellations within 30 days of the course, including no shows. Substitutions with proper notification are acceptable. All materials must be returned prior to receiving a refund. No shows will not be rescheduled or receive a refund.
The ATLS manual will be mailed via USPS one month prior to course date. Your pre-test will be emailed to you from facs.org, also one month prior to course date.
For questions, please contact Moni James EMT-P EMSI, ATLS Coordinator at 216-286-0820 or email at atls.rainbow@uhhospitals.org
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The American College of Surgeons' ATLS Program complies with the American with Disabilites Act (ADA). Any person who needs accommodations under the ADA should contact Moni James EMS-I