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Anesthesiology

FCCS Registration

Please direct inquiries to:
Beverly Fletcher, FCCS Course Coordinator
1211 21st Avenue South, MAB Ste.  526
Nashville, TN 37212
PH: 615-936-2454  FAX: 615-936-7059
Email: Beverly.S.Fletcher@vanderbilt.edu

NEXT AVAILABLE COURSE DATES:
March 5-6, 2016  (FILLED)

May 21-22, 2016 

September 10-11, 2016

November 12-13,  2016

Please indicate course date 

Name 

Address Line One (CANNOT SHIP TEXTBOOKS TO P.O. BOX)

Address Line Two (City/State/Zip)

Cell phone, including area code 
Work phone, including area code 

Email address 

Employment/School: (facility/affiliation/organization)

Position  

Area of Specialty

Are you a: (Please check one)

Physician     Physician Assistant      Respiratory Therapist

   Pharmacist  RN    NP   NP Student    Other

If Other, please indicate professional role:  

Please list all degrees

What course status are you applying for *
(Please select only one. See bottom of form for explanations.)

Provider status Associate Instructor  Instructor

Registration fees

Attending physicians: $400
RNs, NPs, PAs, pharmacists, respiratory therapists, paramedics, residents,
fellows, medical & NP students: $300

Note: If you are employed by Vanderbilt, please inquire about discounted rates.

Make checks payable to Vanderbilt University Medical Center. Checks, with the note that the payment is for FCCS Course registration, should be sent to the attention of:

Beverly Fletcher, VUMC FCCS Course Coordinator
1211 21st Avenue South, MAB Ste.  526
Nashville, TN  37212

CREDIT CARD INFO:
Note: You can call Beverly Fletcher directly at 615-936-2454 to provide your credit card payment information. If paying with internal 1180, please indicate department and who will be sending.

Please indicate how you will be paying:

Check  Credit Card  Departmental Payment (1180)    1180 will be sent from:________________

ENROLLMENT POLICY:

You will be informed of your acceptance to the selected course above by email. If a class is full, you will be informed of the next available course dates.

*Status Explanation

Instructor Status Prerequisites

  • Physicians - Critical Care Certification or Eligibility
  • Nurses - ACNP/CNS/CCRN or having a master's degree in Nursing with a specialization in Critical Care
  • SCCM membership
  • Complete two-day instructor course
 
Associate Instructor Status Prerequisites
 
  • Physicians & Nurses - Have considerable experience in Critical Care, but not meeting criteria for Instructor Status above
  • Must complete the two-day FCCS Provider course
  • SCCM membership
  • Associate Instructors can obtain Instructor status after two teaching experiences in FCCS Provider courses under the direction of FCCS Course Director
 
Provider Status Prerequisites
 
  • Any clinical professional who does not have significant experience/activity in critical care medicine
  • SCCM membership is NOT required.
  • Does need to complete two-day instructor course
     

 

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