PALS Forms :: IHS Training Center :: UnityPoint Health - Des Moines | Check out the course paperwork for renewal and provider

UnityPoint Clinic Urgent Care - Altoona

2720 8th St. SW
Altoona, Iowa 50009

01 Patients
Waiting Now

UnityPoint Clinic Urgent Care - Ingersoll

2103 Ingersoll Ave., Ste. 2
Des Moines, Iowa 50312

01 Patients
Waiting Now

Urgent Care - Ankeny

3625 N. Ankeny Blvd.
Suite E
Ankeny, Iowa 50023

07 Patients
Waiting Now

Urgent Care - Lakeview

6000 University Avenue
Suite 101
West Des Moines, Iowa 50266

09 Patients
Waiting Now

Urgent Care - Merle Hay

4020 Merle Hay Road
Suite 100
Des Moines, Iowa 50310

09 Patients
Waiting Now

Urgent Care - Southglen

6520 SE 14th St.
Des Moines, Iowa 50320

02 Patients
Waiting Now

Urgent Care - Urbandale

2901 86th Street
Urbandale, Iowa 50322

03 Patients
Waiting Now
UnityPoint Health - Des Moines

PALS Forms

Course Paperwork (Provider and Renewal)

Submit prior to the course

*If you modify the agenda set forth in the instructor manual, you must also submit this to the CTC for approval prior to the course.

 Submit all forms within 2 weeks following the course.  

  • PALS Roster - one per course    
  • Participant Registration - one per student
  • Card Order Form(pdf) or Card Order Form(Word) - one per course
  • BLS Skills Testing:  Child & Infant- one per student
  • PALS Core Cases
    • PALS Case Scenario Testing Checklists - (1 Cardiac case & 1 Respiratory OR Shock case)
  •  Written Test Answer Sheet- one per student

HeartCode PALS 

  • PALS Core Cases        
    • 2016-PALS Case Scenario Testing Checklists - 2 cases per student (1 Respiratory or shock, 1 cardiac)
  • Heartcode completion certificate

PEARS Course Paperwork

Submit prior to the course

  • Course Planning Form - submit 3 weeks prior to course if the CTC can share course information with any interested community members. 

*If you modify the agenda set forth in the instructor manual, you must also submit this to the CTC for approval prior to the course.

Submit within 2 weeks following the course