WINNIPEG POLICE SERVICE
FIRST AID/CPR REPORT
The Winnipeg Police Service requires a valid Standard First Aid and a basic level
Cardio Pulmonary Resuscitation (CPR) certificate, prior to an offer of employment.
Please have the form (on the reverse side of this paper) completed by an
organization whose standards are recognized as equivalent under the Manitoba
Workplace Safety and Health First Aid Regulation 140/98R or under the Canada
Occupational Health and Safety Regulations. This form must be accompanied by the
original certificates.
The program must contain the following elements:
First Aid
CPR
-
Emergency Scene Management
Shock, Unconsciousness & Fainting
Artificial Respiration
Choking
Severe Bleeding
Bone & Joint Injuries – Upper Limbs
Muscle Strains
Medical Conditions
Bone & Joint Injuries – Lower Limbs
Head/Spinal and Pelvic Injuries
Chest Injuries
Wound Care
Environmental Illnesses & Injuries
Burns
-
Signs, Symptoms & Actions
1 Rescuer CPR (Adult)
Risk Factors
Healthy Heart Habits
Choking
2 Rescuer CPR (Adult)
CPR for Infants to one-year old
CPR for Children (1-8 years)
Artificial Respiration for Infants & Children
(PLEASE SEE REVERSE)
FIRST AID/CPR REPORT
APPLICANT’S NAME: _____________________________________________
NAME OF ORGANIZATION:________________________________________
ORGANIZATION ADDRESS:________________________________________
PHONE NUMBER ___________________ CURRENT DATE: _______________
I HEREBY CERTIFY that the applicant _____________________________ has
successfully completed a First Aid Certification Program and a Basic Rescuer
Cardiopulmonary Resuscitation Program, which contains the following elements:
First Aid • Emergency Scene Management
• Shock, Unconsciousness & Fainting
• Artificial Respiration
• Choking
• Severe Bleeding
• Bone & Joint Injuries – Upper Limbs
• Muscle Strains
• Medical Conditions
• Bone & Joint Injuries – Lower Limbs
• Head/Spinal and Pelvic Injuries
• Chest Injuries
• Wound Care
• Environmental Illnesses & Injuries
• Burns
CPR •
•
•
•
•
•
•
•
•
Signs, Symptoms & Actions
1 Rescuer CPR (Adult)
Risk Factors
Healthy Heart Habits
Choking
2 Rescuer CPR (Adult)
CPR for Infants to one-year old
CPR for Children (1-8 years)
Artificial Respiration for Infants &
Children
Certification Date:__________________
Year / Month / Date
Expiry Date:____________________
Year / Month / Date
Certification Date:___________________
Year / Month / Date
Expiry Date:____________________
Year / Month / Date
PERSON CERTIFYING EQUIVALENCY:
________________________________
______________________________
Please print
Signature
Please validate the results with
an official office stamp.
2009 09 18