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
October 6, 2016
October 17, 2016
October 27, 2016
November 1, 2016
November 11, 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?
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
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

Rebecca Gregory

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

Contact Rebecca


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.

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