CPR Safety Survey

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CPR Safety Survey

* Indicates required question

Email *

Your email

Your Name *

Your answer

Are you CPR - C certified? *

Yes

No

If you answered 'Yes' to the question above, when does your certification expire?

MM

/

DD

/

YYYY

Are you CPR - AED certified? *

Yes

No

If you answered 'Yes' to the question above, when does your certification expire?

MM

/

DD

/

YYYY

Are you interested in gaining/renewing your CPR-C and CPR-AED certification? *

Yes

No

Maybe

How would you describe your swimming ability

I am an excellent swimmer ( Can swim 100m +)

I am a good swimmer ( Can swim 50m)

I don't swim often ( Can swim 25m)

I cannot swim

Other:

Clear selection

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