ReNurse Academy Skills Booster
Course Registration
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Are you currently enrolled in a Practical Nursing Program?
*
Yes
No
Name of School
Graduation Date
-
Month
-
Day
Year
Date
Have you graduated recently or in the past from a Practical Nursing Program?
*
Yes
No
Name of School
Graduation Date
-
Month
-
Day
Year
Date
Please check all topics you feel are your weakest areas:
*
Airway management
Bowel elimination
Comprehensive Head to Toe Evaluation of an Adult
Enteral tube feeding
Surgical asepsis
Medication administration
Urinary elimination
Wound Care
Other
Please check all procedures that you have experience in. This will assist ReNurse Academy's instructors in ensuring competency in all key skills.
*
Airway suctioning/Oxygen management
Assisting client with bed pan/urinal
Assisting empty colostomy bag
Bed baths/sponge baths
Bed making/linen change
Bedside commode
CPR
Empty foley bag
Enemas
Fall precautions
Feeding patients
Hoyer lift
Mechanical beds
Oral Hygiene/dental care
Peri care/diaper care
Proper assist with transfers/ambulation
Range of motion exercises
Skin care
Trapeze
Wheelchair--proper use of restraints/posey's
Oral temperature measurements
Rectal temperature measurements
Urinary catheter care
Are you familiar with the following? Check all that apply.
*
Alzheimer's/Dementia
CVA
Diabetes
FX hip
Heart patients
Parkinson's
Place a check next to each statement as acknowledgement of the course requirements
*
I am aware that this is an 8 hour skills refresher course
I acknowledge that I will be required to submit (a copy of government ID, proof of LPN school enrollment or copy of nursing license, Covid Vaccination or Negative test results) to Castle Branch who is ReNurse Academy's document manager.
I hereby verify that all of the information contained in this document is accurate and truthful to the best of my knowledge
Signature
*
Application Completion Date
*
-
Month
-
Day
Year
Date
Your Total
*
prev
next
( X )
Skills Booster
$399.00
$
399.00
Skill Booster Course Fee
Enter coupon
Apply
Total
$0.00
$
0.00
Credit Card
Submit
Should be Empty: