BLS Update Registration Form 

NCBH/School of Medicine/WFBH Community Physicians Employee 

NOTE: Find the date you would like to attend on the left, and pick a time to attend that class on the right. Please choose only ONE date and time to attend.

 

 Date to Attend Time to Attend
July 15, 2016  
July 26, 2016     
August 2, 2016     
August 11, 2016       
August 29, 2016  
September 1, 2016  
September 14, 2016  
September 30, 2016       
October 6, 2016
October 17, 2016
October 27, 2016
November 1, 2016
November 16, 2016
November 30, 2016     
December 1, 2016     
December 19, 2016     

 

   
Are you an NCBH, School of Medicine, or
WFBH Community Physicians Employee?
*Note to ALL School of Medicine/Health Sciences
and WFBH Community Physicians Employees:
Please send a signed and completed authorization form to Life Support Education
BEFORE the scheduled day of class. This form must be completed by the
administrative person in your area and allows us to bill your department for the course.
This is a requirement to attend class. You can find this form on the Life Support Education
website under FORMS.
Last Name
First Name
Middle Initial
Employee ID
Credentials (MD, RN, etc)
Phone Number
Alternate Phone Number
Department Name
Department Number
E-mail Address
Re-Enter E-mail Address
Comments/Concerns  
We will notify you of your acceptance into the class through the e-mail 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

 

3rd Floor South Building

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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.