Skip Navigation

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
July 14, 2017  
July 17, 2017  
July 24, 2017  
August 2, 2017  
August 11, 2017  
August 21, 2017  
August 24, 2017  
September 11, 2017  
September 14, 2017       
September 25, 2017  
October 4, 2017  
October 16, 2017  
October 26, 2017  
October 30, 2017  
Last Name
First Name
Middle Initial
Employee ID  
Credentials (MD, RN, etc)
Phone Number
Alternate Phone Number
Department Name
E-mail Address
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

Rebecca Gregory

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

Contact Rebecca


3rd Floor South Building

Find a Doctor Ways to Give
Five Wake Forest Baptist Specialties Earn U.S. News RankingsComprehensive Cancer Centers National Designation is RenewedMagnet Hospital Recognition2015 Best DoctorsJoint Commission Report

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.

© Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157. All Rights Reserved.