Instructor Records Transfer Request
When an instructor moves to a different Training Center, three parties complete this form in order: the accepting Training Center Coordinator, then the instructor, then the current Training Center Coordinator. The current TCC returns the completed form together with the instructor’s records to the accepting TCC. The accepting TCC contacts the instructor once the transfer is finished.
Fill in every field that applies to you, sign in your signature box, and date it. Your entries save automatically in this browser on this device as you type.
Ella Med will not release, forward, or transfer any instructor records, rosters, or course documentation until a fully completed and properly signed form has been received. Incomplete or unsigned forms will be returned without action.
This page reproduces the fields of the AHA Instructor Records Transfer Request so you can complete it on a phone, tablet, or computer without the neext to print it or scan it. However the The official AHA PDF is available here, you can use that version as well. We want you to do what works the easiest for your situation: AHA Instructor Records Transfer Request (PDF). If your accepting Training Center requires the AHA PDF specifically, use that file instead.
To find a Training Center to transfer to, search the AHA Atlas at atlas.heart.org.
Our Training Center is willing to accept the instructor named below as an instructor at our Training Center. We agree to keep and maintain all instructor records in accordance with our TC Agreement with the AHA and the Program Administration Manual.
All applicable instructor records, as outlined in the Program Administration Manual, must be transferred. The transferring Training Center keeps copies of all transferred records for three (3) years.
Save the completed form as a PDF, then email it to ellamed.org@yahoo.com. Ella Med support hours are Monday through Thursday.
Your typed entries and your signature are both included in the PDF automatically.