Registration Form: Basic Life Support (BLS) Course
BASIC LIFE SUPPORT (BLS) COURSE & AED - FOR PROVIDER
*modules will be based on AHA 2020 Guidelines
(HEALTHCARE PROFESSIONALS & PUBLIC)

Organized by: NATIONAL HEART ASSOCIATION OF MALAYSIA
In collaboration with: MALAYSIAN SOCIETY OF CARDIOVASCULAR TECHNOLOGIST

📍 Training venue:
National Heart Association of Malaysia, D-13A-06, Menara Suezcap 1, KL Gateway,
No.2 Jalan Kerinchi, Gerbang Kerinchi Lestari, 59200 WP Kuala Lumpur - MALAYSIA
Map: https://goo.gl/maps/442BJJgYGG9LTUDYA

🚘 Parking Fee: Flat rate RM 3.00 parking at KL Gateway Mall (sharing parking with office tower) on Sunday - Cashless Parking
📞  +603 7931 7900  (Ms. Amirah, Training Coordinator)
🌐 https://malaysianheart.org/index.php?p=highlights&a=1000

Training Format:
1 Full Day of FULL COURSE,  PHYSICAL TRAINING only, must attend in-person.
Refresher / renewal course and online training format are NOT AVAILABLE.

CPD Points:
8 CPD points approved for Doctors (regulatory body: MMA)
6 CPD points approved for Assistant Medical Officer (regulatory body: LPPP MYCPD)
6 CPD points approved for Registered Nurse (regulatory body: LJM MYCPD)

Certificate:
Certificate of Competency (valid for TWO years) will be awarded at the end of the course (SAME DAY) if you fulfill the minimum requirement to pass the exams (assessment on theory and practical)

Course Material:
Download link for course booklet will be provided to confirmed* participants for self-study prior to course
*participant has paid full registration fees

IMPORTANT NOTE:
PLEASE READ and understand the course information above before you fill-in your information.
NHAM BLS Course is NOT AHA-certified as we are not an AHA training centre.
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Email *
Mark your calendar! Registration will be open one-month prior to course date:
Course Date *
Note: WE NEED A MINIMUM OF 10PAX FOR CLASS TO PROCEED. Max per class 20PAX. Date is subject to changes - for latest update please check our website www.malaysianheart.org 
Full Name (as per MyKad / Passport) *
(For printing on Certificate)
MyKad No. (compulsory to provide for CPD claims and certificate issuance) *
(For Non-Malaysian, please indicate your Passport No.)
Mobile No.
*
(For reminder sent via WhatsApp)
Working Place / Hospital
Please note that this course is only open to those practicing locally (MALAYSIA)
Previously attended BLS Course (with NHAM or any other training academy)
*
How did you hear about us
Category *
What is your preferred medium / language? *
The class will be conducted in English but your input will help us understand our audience better
Required
Payment mode *
Payment must be made prior to course. We DO NOT accept cash on-site. Payments made are STRICTLY non-refundable for any reason, only rescheduling is allowed (terms and conditions apply)
*LO/LPO payment not accepted
Registration Fee revision effective 1st March 2024
According to the national fiscal announcement, effective 1st March 2024, the service tax rate will increase from 6% to 8% on all taxable services.   
Registration Fee (Early Bird Fee will be advised by secretariat via email/text) *
(inclusive of 8% SST from 1st March 2024 onwards) - Registration will only be confirmed upon receipt of FULL payment

If you answered GROUP REGISTRATION, please provide name of group contact person for reference
Course Booklet (softcopy provided prior to course)
*
All confirmed participants will receive a download link (via email) of the course booklet in PDF for self-study prior to course.

However, if you wish to have the printed copy (A5 size booklet) provided on training day, RM 7/book will be charged to you. Please indicate your preference below:
SUCCESSFUL COMPLETION OF COURSE - to be awarded the Certification of Competency, you MUST fulfill the following conditions:
✅ Demonstrate competent BLS skills in all BLS modules skills testing
✅ Achieve a minimum score of 90% in the 40 questions MCQ test (online test, require mobile device to scan QR)
✅ Attend at least 45mins of the theory lecture

No Certificate of Competency will be awarded if you do not fulfill any of the above conditions.
*
Required
I understand that if I have successfully registered for this course (and payment made), should there be postponement by the organizer due to unforeseen circumstances (such as MCO / LOCKDOWN / SOP RESTRICTIONS / INSUFFICIENT NUMBER OF PARTICIPANTS) - my participation will be rescheduled to the soonest available date per offered by organizer. I fully understand that ALL PAYMENTS MADE ARE NON-REFUNDABLE, only change of date is allowed according to organizer's terms and conditions. Any payments made after the class is full will be pushed to the next available date. If I fail to attend the course without prior notice given to the organizer, my participation will be forfeited and not rescheduled. *
Required
EARLY BIRD REGISTRATION RATE
Early Bird Registration Rate is available if you secure your seat early - cut off date for Early Bird rate will be advised by secretariat via email.  
For enquiries, please contact:
👩 Secretariat, National Heart Association of Malaysia (Ms. Amirah)
📞 +603-7931 7900

📝 Secretariat will respond to you via email from secretariat@malaysianheart.org (please check in junk/spam/deleted folder if not received in your inbox) with the payment information within 2-3 WORKING DAYS (not inclusive Saturday, Sunday & Public Holidays). Appreciate your patience!

📌 Registration will only be confirmed upon receipt of full course fees
📌 Strictly no walk-ins allowed
📌 All payments made is non-refundable, only change of date is allowed (subject to terms & conditions)

A copy of your responses will be emailed to the address you provided.
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