Fillable Registration and Application for issuing Occupational First Aid (Wellington City Council New Zealand)

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Registration and Application for issuing Occupational First Aid (Wellington City Council New Zealand)

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1-1
Jurisprudence Application for Occupational First Aid
June 2018
Registration and Application for issuing Occupational First Aid
Certification to Out of Jurisdiction Certificate Holders
Instructions:
Please complete this registration form. The form must be signed and dated.
Once complete please send along with a copy of your current certificate to
bcy.ooj@sja.ca for final processing.
Please Print
Surname
Given Names in Full
Mailing Address
Date of Birth
Month Day Year
City
S.I.N. (optional)
Work Phone#
e-mail address
Home Phone#
Employer
Occupation
Employer Address
City
Province
Postal Code
Out-of-jurisdiction certificate information
Certificate Level
Province issued in:
Certificate Number
Expiry date:
Please sign to indicate that you, the applicant,
Agree to abide by the principles of first aid and the terms and conditions of certification
as outlined in the Occupational First Aid Reference and Training Manual and
Occupational Health and Safety Regulation (OHSR) as stated on the reverse of this
document; and
Agree to read and complete the Occupational First Aid Out of Jurisdiction Jurisprudence
Package issued by the agency prior to working as a designated first aid attendant on a
worksite in British Columbia.
Applicant’s Signature
Date:
1-2
Jurisprudence Application for Occupational First Aid
June 2018
Terms and Conditions of Certification
The attendant must
(a)
follow the principles of first aid treatment as outlined in the Board’s
Occupational First Aid training programs that are provided to the attendant
when he or she participates in the training program,
(b)
comply with the OHSR, and the other responsibilities of attendants in this
standard, and
(c)
comply with any other terms and conditions provided to the attendant by the
training agency when granted certification or provided to the attendant by
the Board at any other time.
Including:
The first aid certificate holder must not engage in inappropriate conduct, not restricted to
but including:
smoking while assessing or treating an injured or ill worker and/or
while handling oxygen therapy equipment, or permitting others to do
so;
failure to use the assessment and injury treatment techniques
outlined in first aid training courses unless conditions precluded
them;
conduct that poses an unreasonable threat to the safety and well-
being of other workers or the public;
removing themselves from being able to see or hear any
summons for first aid at a workplace;
abandonment of an injured worker after beginning assessment or
treatment;
refusal to treat an injured worker when acting as the
designated attendant; or
treating or transporting an injured worker while impaired or under the
influence of drugs or alcohol.
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Registration and Application for issuing Occupational First Aid (Wellington City Council New Zealand)

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Completed 18 January 2022

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