Outside Student
NRP Registration Form 

PLEASE NOTE:
All registrations must be received and the class must be paid for no later than 10 business days prior to the course in order for you to receive your book with enough time to adequately prepare and complete the online test. 

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

 

 

Time to Attend Date to Attend
8am - 12pm
   
Last Name
First Name
Middle Initial
Credentials (MD, RN, etc)
Address
City
State
Zip Code
Phone Number
Alternate Phone Number
Employer
E-mail Address
Last Four of Your Social Security Number
Month and Day of Your Birthday
    
Fee for Course   $140  
Method of Payment:
                    
  

If paying by check, please address to:

Department of Life Support Education
Wake Forest Baptist Medical Center
Medical Center Boulevard
Winston-Salem, NC 27157 

If paying by credit card, please call Tiffany Loggins at 336-716-2800 once you have received confirmation of your acceptance.

If paying in cash, please deliver in person to the Department of Life Support Education-3rd floor South Building.
    
    
    
    
Comments/Concerns  
We will notify you of your acceptance into the class through the email address you provided.

 

Quick Reference

Life Support Education
Tiffany Loggins
For BLS, ACLS, & ITLS Questions

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

Contact Tiffany
tloggins@wakehealth.edu

Jill Pettit
For PALS, NRP, ENPC, TNCC, PITLS, & E-Learning Questions

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

Contact Jill
jpettit@wakehealth.edu

3rd Floor South Building
Find a Doctor Ways to Give
USNWR 2013-2014Magnet Hospital RecognitionConsumer Choice2014 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.