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Run: CPR and BLS Certification Tracking

Track CPR and BLS certification dates, expiration, and renewal status for clinical staff in one audit-ready form. Use it to verify who is current, who needs ...

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Log Entry Details

Record ID

Auto-generated unique identifier for this certification log entry.

Date of Entry (required)

Date this certification record is being logged.

Entered By (Name or Employee ID) (required)

Name or ID of the person submitting this record (may be the staff member or their supervisor).

Department / Unit (required)

Department or clinical unit where the staff member is assigned.

Staff Member Information

Staff Member Full Name (required)

Employee ID (required)

Use the organization's assigned employee ID. Do not enter Social Security numbers or other government-issued identifiers.

Job Title / Role (required)

Employment Status (required)

Certification Details

Certification Type (required)

Select the specific certification earned by the staff member.

Other Certification — Please Specify

Certifying Organization (required)

Organization that issued the certification card.

Course Delivery Format (required)

Indicate how the course was completed. Note: AHA requires a hands-on skills session for BLS certification regardless of online completion.

Certification Card / eCard Number

Enter the unique ID printed on the certification card or eCard. Leave blank if not applicable.

Certification Completion Date (required)

Date the staff member successfully completed the course and earned certification.

Certification Expiration Date (required)

AHA BLS certifications are valid for 2 years from the issue date. Enter the date printed on the certification card.

Certification Card / eCard (Upload) (required)

Upload a photo or PDF of the front of the certification card or AHA eCard confirmation. Accepted formats: JPG, PNG, PDF.

Renewal Schedule and Reminders

Days Until Expiration (Calculated)

Automatically calculated from the expiration date. Review this value to prioritize renewal urgency.

Renewal Reminder — Notify Staff Member At (required)

Select all intervals at which the staff member should receive a renewal reminder notification.

Planned Renewal Method

How does the staff member plan to renew this certification?

Renewal Course Scheduled Date (if known)

If a renewal class is already booked, enter the scheduled date.

Renewal Notes

Any additional context about the renewal plan, scheduling constraints, or accommodations needed.

Manager Review and Audit Trail

Certification Card Verified by Manager (required)

Confirm that the physical or electronic certification card has been reviewed and matches the information entered above.

Verification Issue — Details

Staff Member Cleared for Patient Care Assignments Requiring BLS (required)

Based on this certification record, confirm the staff member's eligibility for assignments that require current BLS credentials.

Reviewing Manager / Credentialing Coordinator Name (required)

Reviewer Title (required)

Date of Manager Review (required)

Reviewer Signature (required)

Electronic signature confirms the accuracy of this certification record and manager verification.

Additional Comments or Follow-Up Actions

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