Inspection

FIRST AID CPR/AED COURSE ROSTER
COURSE COMPLETION DATE:

TOTAL HOURS OF INSTRUCTION:

NUMBER OF STUDENTS WHO WILL BE ISSUED A CARD:

LEAD INSTRUCTOR:

LEAD INSTRUCTOR ID#

ASSISTING INSTRUCTOR:

ASSISTING INSTRUCTOR ID#

INSTRUCTOR / STUDENT / MANNEQUIN (RATIO):

WHO DECONTAMINATED THE MANIKINS:

COMMENTS:

Participant List

First Name

Middle Initial

Last Name

Email Address (E-Cards)

Telephone

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.