Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Healthcare Provider BLS Course Registration

  1. Heartsaver Health Care Provider BLS Course Date*

    Please choose a 2023 course date:

  2. Are you taking this course as an individual or part of a corporate group? If in a group, please identify the group.
  3. Payment Policy
    There is a minimum requirement for the number of course attendees. If this minimum requirement is not met, the course will be canceled for that evening. If canceled, a refund will be issued and applied to the account/card issued within five (5) business days. Each attendee will be notified by phone with a reminder, and/or update to the status of the course. Credit card payment will be processed at the time it is submitted. Please note: If course registration is within two (2) days of the class, please contact the fire department directly for space availability at (630) 671-2841.
  4. Payment Instructions
    Paying by credit card: hit Submit and follow directions on the confirmation page to pay the $60 course fee by credit card. Convenience charges apply to online credit card payments.
  5. Leave This Blank:

  6. This field is not part of the form submission.