ERC -IMMEDIATE LIFE SUPPORT (ILS) COURSE 2018- Sri Lanka
Course will be held @ the college of Anaesthesiologists of Sri Lanka –Colombo 8 ( Opposite Lady Ridgeway Hospital – Maradana road entrance)
ERC- ILS -Course Fee 4000 Rs- Target group- Nurses, Preinterns, Doctors in non acute care
1.Select preferred ERC-ILS course date
Target group- Nurses, OPD & Community based doctors,Physiotherapists, Preinterns
2. Full Name
As per your ID card/Passport/Birth Certificate
3. Surname followed by initials
e.g; Premaratne E.M.J
4. How your name should appear on the certificate
Please double check the Name.
5. First name
For the name tag
6. Mobile number
If answer is other @Please mention in your comments
8. Specialty / Area of practice
9. If your answer is "Other" to above question, state the specialty or place of work
10. Hospital/ Institution
e.g , P.G.H Badulla , D.G.H. Gampaha / B.H. Panadura / NHSL / Locum, None
11. Date of Birth
e.g- Colombo University , Kandana NTS or other
13. If your answer is "Other for above the question, fill with appropriate answer
14. Post graduate qualification if any
e.g- Diploma/MSC - Nutrition, DFM,
15. SLMC Registration number
If not registered yet , indicate " No"
16. Have you completed any of following life support courses with in last 2 years ?
ILS - Sri Lanka
17. Meal preference
18. Any special requests/comments
Different course date, CPR courses done, Special assitance
19. I hereby agree that the above information are true and correct according to my knowledge, and will check my email box and respond accordingly
A copy of your responses will be emailed to the address you provided.
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