American Red Cross

First Aid – When Help is Delayed

ORIENTATION VERIFICATION FORM

 

The purpose of this form is to verify that American Red Cross Lay Responder First Aid and CPR/AED instructors wishing to teach the First Aid – When Help is Delayed  have received all necessary information and oriented themselves to the new material. Once you have completed your self-orientation, complete this form and submit it to your American Red Cross unit of authorization. Upon receipt of this completed and signed form, your unit will give you authorization to teach this course.

Name___________________________________________________________________

Address_________________________________________________________________

Telephone: (Home)________________________(Cell)__________________________

 

Current instructor authorizations):

____Lay Responder FA & CPR/AED Instructor

____First Aid – Responding to Emergencies

____Emergency Response

____Lifeguarding

 

         I verify that I have reviewed the following materials (check box when appropriate):

         ____When Help is Delayed Participant Manual

         ____First Aid - When Help is Delayed Instructor Manual

         ____First Aid - When Help is Delayed Self-Study Guide

 

Signature_________________________________________Date___________________