Certification Card.

(1)

The name of the individual completing the course

(2)

The course completion date

(3)

Certification expiration date

(4)

Certification number

(5)

The title of the card shall be listed as: Epinephrine Auto-injector Certification.

(6)

The signature of the certified Health and Safety Code Section 1797.197a Responder, affirming the statement: “I understand the scope of my authority and responsibilities as a trained Health and Safety Code Section 1797.197a Responder, and will possess and only employ epinephrine consistent with that Health and Safety Code Section 1797.197a training and applicable law, including activation of the Emergency Medical Services System and record keeping.”