1. Healthcare and Public Safety Training
TheAm-,RedCross is••BSllldin IN11i,gabout)'Ot6lrairliige,tpe,ienoe. Pllaase.,_, usbyaasqa119 fie
followaigque,rans.
Your nslrudorshouldhaveprov,dedinfonnationfor
0ueswns1-2.
Ifnot planego<ill!ldlytoQuaswn3 .
1. Four�lorahancode
_7__o__•__o_
2. Cotneoffemgcode
ll £.SB. 1'..S. l.. Cl-1
4 . "*=!,eot.ne(s)are youevaklatingIOday?
(Chedcalllaf8')ply)
� 8a9icUeSupportforI leallhcaePn:!Ydefs
D CPR/AEDforP,ofessi..... R8SaJel'Sand
Ileallhcare Provldals
0 EmergancyMt:tica!Ra�(EMR)
D M11ns111ting EITlelg8rlCfOxygen
0 Olhar,pie edarccba...::.:.:.......::...____
5 . DatelZ.e
!"!5
co,r,plefed(WOOIYYYY)
lo li2!l!Sl
6 Have)'OUtalcenhstn,ed11aili,g bebemmfieRed
Crossaanotherogalizallcn? (Checkcnyone}
� Yes masl ,eca.iytran RadCross
0 Yes, mostr-lllyfrornanotwagaiizai11
D No
7. Whaloommen&s�youIketosha"e abo.ths
baiiq?
Vu e.D/t.pR- ��uz..
8. Ooyou�'h!ie.,.-,c:llhisausetobe<.
D Toostm �.l.tstllf1' 0 ToobV
9 . WhlllbastdesatlasyoAJ1posiion?(Chedtalthataq>ly)
0 PLfllic Safety(i.e. rn Police, EMS)
� lleall1C«a(i.e.. Physician. Nine. Phauuarist.
Denlisl)
0 hpldlics{ia�Iiegl�WallerSali!tylnstru:::la-)
D Other-.pleasespecly________
10. 'IMlalISOfdbe yoAJ1pc,&),oofL8. Par.medic. Nl.nng
Sludanl
)
�
��
0 Yes � No
12 Did)'OUhawmotelhanone inslrudorfayoAJ1class? 0 Yes
13. °"8rall, towwouldyourateht
i'lAtJdor(s)l18t� )"!Urclass?
&c1l1nt
0
v.,,,
-k
-. "-
0 a a
lhad
-------l>ef
--ED ....... __,
0 0
14 Wot*!)'OUbewdingto allowtheAmerica, RadCrosstofolowt.pWllhyoureoa,diu)'OtJo'WISlrl.arerlranrig
expeiiance?(Nole: WeurlortlS'lalel)'may not be abletofolowupwllh�)
ji( Yes O No
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