COVID-19 Vaccination Training Registration
Name
*
First Name
Last Name
Email
*
Confirmation Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Occupation
*
Please Select
Doctor
Nurse
Paramedic
EMT
Dentist
Physiotherapist
Occupational Therapist
Healthcare Assistant
Other
Registration Number
Please enter your MRC, NMBI, CORU or PHECC registration number here.
Employer
*
Place of work
*
Do you have a current Basic Life Support certificate from the Irish Heart Foundation or PHECC?
*
Yes
No
Date of Expiry of your Basic Life Support Certificate
*
-
Day
-
Month
Year
Date
Do you have a disability or medical condition that may impact your ability to complete online training?
*
No
Yes
Please provide more information about your disability or medical condition
Do you have a disability or medical condition that may impact your ability to complete face-to-face skills training in basic life support, anaphylaxis and vaccine administration?
*
No
Yes
Please provide more information about your disability or medical condition
Precision Health will collect and store your personal data in accordance with GDPR regulations. Precision Health will pass your name and course outcomes to the Health Service Executive and Irish Heart Foundation as part of the course certification process. Precision Health will retain your data for 2 years as required for certification records, after which time your personal data will be removed and anonymous records retained. More information available on our data privacy policy.
I consent to my data being processed as described
Attended Onsite Training
Yes
Did Not attend
Skills Assessments Passes
Yes
No
Submit
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