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MRC Screening Form

  1. Whatcom County Medical Reserve Corps Screening Form
  2. Availability
  3. Skills and Training
  4. Are you currently certified as an ACLS and/or BLS provider?
  5. If "No," do you have plans to become current?
  6. Are you currently affiliated with a disaster relief organization?
  7. Are you currently registered as an emergency worker?
  8. Credentials*
  9. Are you currently licensed in Washington State?
  10. You will be asked to present your license or certification at a later date.
  11. Have you completed ICS Training?
  12. Are you interested in non-medical support? Such as record keeping, training set-ups, etc? Can we reach out with volunteer opportunities?
  13. Leave This Blank:

  14. This field is not part of the form submission.