November 16, 2017 JSOMTC Administrator AHA Credentials request SOCM or SFMS course issued AHA cardsComplete this form if you are requesting duplicate AHA credentials originally issued to you while attending the SOCM or SFMS courseName *FirstLastCourse you were enrolled in for the AHA training *Special Operations Combat Medic (SOCM)Special Forces Medical Sergeant (SFMS)Class numberApproximate date you completed the AHA training *Month/YearYour email *EmailConfirm EmailPhone number *Fax number (optional)Your mailing address *This is the address we will mail your duplicate cards toDuplicate cards you are requesting *Basic Life SupportAdvanced Cardiac Life SupportIf your cards are due to expire in the next 60 days we cannot issue you new cardsEmailSubmit SOCM/SFMS request SOCMSSC course issued AHA cardsComplete this form if you are requesting duplicate AHA credentials originally issued to you while attending the SOCMSSC courseName *FirstLastCourse you were enrolled in for the AHA training *Special Operations Combat Medical Skills Sustainment Course (SOCMMSSC)Class numberApproximate date you completed the AHA training *Month/YearYour email *EmailConfirm EmailPhone number *Fax number (optional)Your mailing address *This is the address we will mail your duplicate cards toDuplicate cards you are requesting *Basic Life SupportAdvanced Cardiac Life SupportIf your cards are due to expire in the next 60 days we cannot issue you new cardsNameSubmit SOCMMSSC request
