Thank you for your interest in taking a PEARS or NRP class at North Ottawa Community Health System. Please fill out the form below and also indicate what class you are interested in attending. CLick Here for the 2020 Schedule. If you have any questions, please contact CHRISTA FOLKERT at 616.847.5671 or CFOLKERT@NOCH.ORG . Thank you.

PEARS & NRP information required:

Name:

Your Contact Phone Number:

Your Zip Code:

Your Email Address:

Your Manager's Name:

Are you are current NOCHS employee? Please Choose One Yes No

Status: Please Choose One Full Time Part Time Casual/PerDiem

If so, what department (e.g. ICU, ED, etc.)?

What class are you interested in taking? Please Choose One PEARS NRP

Please indicate the date and time you would like to attend for your class:

Do you hold current certification in this course? Please Choose One Yes No

    If NO, how long has your certification been expired? Please Choose One Still Current Expired less than 30 days Expired for 31-90 days Expired longer than 90 days Expired longer than 1 year Never had certification

Would you like to purchase a new book (NRP/PEARS-$40) or rent one for free? 

RQI BLS, ACLS, PALS enrollment request:

Which course is required for your current position? Please Choose One BLS ACLS PALS

How long has your certification been expired? Please Choose One Still Current Expired less than 30 days Expired for 31-90 days Expired longer than 90 days Expired longer than 1 year Never had certification

Name:

Your Contact Phone Number:

Your Zip Code:

Your Email Address:

Your Manager's Name:

Are you are current NOCHS employee? Please Choose One Yes No

Status: Please Choose One Full Time Part Time Casual/PerDiem

If so, what department (e.g. ICU, ED, etc.)?