Employee BLS Provider Registration Form

 

Are you a Cornerstone, Wilkes Regional, Travel Nurse,  
NCBH, WFUHS, or Community Physicians Employee?
   
Date to Attend Time to Attend
January 4, 2017  
January 20, 2017  
January 30, 2017  
February 6, 2017  
February 10, 2017  
February 14, 2017       
March 2, 2017  
March 16, 2017  
March 21, 2017  
March 23, 2017  
   
Last Name
First Name
Middle Initial
Employee ID
Credentials (MD, RN, etc)
Phone Number
Alternate Phone Number
Department Name
E-mail Address
   
Comments/Concerns  
We will notify you of your acceptance into the class
 through the email address you provided.

 

Quick Reference

Life Support Education
Mikell White

Phone 336-716-2800
Fax 336-716-5927

Contact Mikell
miwhite@wakehealth.edu

Rebecca Gregory

Phone 336-716-2888
Fax 336-716-5927

Contact Rebecca
rbgregor@wakehealth.edu

 

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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

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