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MCLC ACLS Registration

Medical City Las Colinas
Classroom #4
Medical Office Building

MCLC Employee ACLS Course Registration Form

¹If you choose ACLS & BLS Renewal, you will stay an estimated 60 minutes later to complete the requirements to renew your BLS. • You will be required to demonstrate BLS Skills (adult, child, infant) & take a 25 question written test (see attached study material in confirmation email). • You do not need to complete the online BLS course if you choose the ACLS & BLS option. Please do not register separately for BLS.  
The American Heart Association has made it MANDATORY that you take the ACLS Pre-Course Self-Assessment and score a minimum of 70%, prior to the course. You can access this at and use the code "acls15".  You must print and bring a copy of the results to the class for admittance.

By checking this box, you agree to complete the AHA ACLS Pre-Course Self-Assessment with a minimum score of 70% and bring a copy of the results to the class.

  • A copy of this form will be sent to the Medical City Las Colinas Education Department for approval.
  • After submission, you will receive an email confirmation. Please be sure to verify that all the information is correct.
  • If you are unable to attend the course that you have registered for, please notify us at or Jency Abraham, MCLC Education Dept. at
  • You must go to the education department and obtain your ACLS Provider Manual. This is required for attendance.