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Registration: Odyssey Medical Crew Scheduling
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APPLICANT INFORMATION
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First Name
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Last Name
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Address
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City
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Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
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Postal Code
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Email
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Home Number
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Cell Number
Resume
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Primary Certification
Secondary Certification
Additional Certification
ADDITIONAL INFORMATION
Relevant Certification
*
Practical Experience and Relevant Skills
*
Availability
Please select your highest current completed credential
*
Primary Certification Type
Please Select
Athletic Trainer
Chiropractor
Dispatch / Communications
Festival Health / Harm Reduction
First Aid - SFA - Standard First Aid
First Aid - OFA 1 - Occupational First Aid Level 1
First Aid - EFA - Emergency First Aid
First Aid - National Lifeguard
First Aid - Certified Rescue Diver
First Aid - EFR - Emergency First Responder
First Aid - AMFR - Advanced Medical First Responder
First Aid - CSP - Canadian Ski Patrol
First Aid - OFA 2 - Occupational First Aid Level 2
First Aid - OFA 3 - Occupational First Aid Level 3
First Aid - CPR only
First Aid - WFA - Wilderness First Aid Logistics
MD - Attending
MD - Attending - Anaesthesia
MD - Attending - CASEM
MD - Attending - Critical Care
MD - Attending - Emergency Medicine
MD - Attending - Family Medicine
MD - Resident - Yr 1
MD - Resident - Yr 2
MD - Resident - Yr 3
MD - Resident - Yr 4
MD - Resident - Yr 5
MD - Student - Yr 1
MD - Student - Yr 2
MD - Student - Yr 3
MD - Student - Yr 4
Medical Office Assistant / Clerk
ND - Naturopathic Doctor
Nursing - LPN - Licensed Practical Nurse
Nursing - RPN - Registered Practical Nurse
Nursing - RPN - Registered Psychiatric Nurse
Nursing - RN - Registered Nurse
Nursing - NP - Nurse Practitioner
Nursing - Student Yr 1
Nursing - Student Yr 2
Nursing - Student Yr 3
Nursing - Student Yr 4
RT - Respiratory Therapist
RT - Student - Y1
RT - Student - Y2
RT - Student - Y3
Physicians Assistant - PA
Physiotherapist
Pre Hospital - Student (Paramedic)
Pre Hospital - Fire Fighting Professional
Pre Hospital - AEMCA (Ontario only)
Pre Hospital - EMR - Emergency Medical Responder (Licensed)
Pre Hospital - EMR - Emergency Medical Responder (Certificate)
Pre Hospital - PCP - Primary Care Paramedic (Licensed)
Pre Hospital - PCP - Primary Care Paramedic (Certificate)
Pre Hospital - ACP - Advanced Care Paramedic (Licensed)
Pre Hospital - ACP - Advanced Care Paramedic (Certificate)
Pre Hospital - CCP - Critical Care Paramedic (Licensed)
Pre Hospital - CCP - Critical Care Paramedic (Certificate)
Other
*
Primary Certification Expiration
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
Secondary Certification Type
Please Select
Athletic Trainer
Chiropractor
Dispatch / Communications
Festival Health / Harm Reduction
First Aid - SFA - Standard First Aid
First Aid - OFA 1 - Occupational First Aid Level 1
First Aid - EFA - Emergency First Aid
First Aid - National Lifeguard
First Aid - Certified Rescue Diver
First Aid - EFR - Emergency First Responder
First Aid - AMFR - Advanced Medical First Responder
First Aid - CSP - Canadian Ski Patrol
First Aid - OFA 2 - Occupational First Aid Level 2
First Aid - OFA 3 - Occupational First Aid Level 3
First Aid - CPR only
First Aid - WFA - Wilderness First Aid Logistics
MD - Attending
MD - Attending - Anaesthesia
MD - Attending - CASEM
MD - Attending - Critical Care
MD - Attending - Emergency Medicine
MD - Attending - Family Medicine
MD - Resident - Yr 1
MD - Resident - Yr 2
MD - Resident - Yr 3
MD - Resident - Yr 4
MD - Resident - Yr 5
MD - Student - Yr 1
MD - Student - Yr 2
MD - Student - Yr 3
MD - Student - Yr 4
Medical Office Assistant / Clerk
ND - Naturopathic Doctor
Nursing - LPN - Licensed Practical Nurse
Nursing - RPN - Registered Practical Nurse
Nursing - RPN - Registered Psychiatric Nurse
Nursing - RN - Registered Nurse
Nursing - NP - Nurse Practitioner
Nursing - Student Yr 1
Nursing - Student Yr 2
Nursing - Student Yr 3
Nursing - Student Yr 4
RT - Respiratory Therapist
RT - Student - Y1
RT - Student - Y2
RT - Student - Y3
Physicians Assistant - PA
Physiotherapist
Pre Hospital - Student (Paramedic)
Pre Hospital - Fire Fighting Professional
Pre Hospital - AEMCA (Ontario only)
Pre Hospital - EMR - Emergency Medical Responder (Licensed)
Pre Hospital - EMR - Emergency Medical Responder (Certificate)
Pre Hospital - PCP - Primary Care Paramedic (Licensed)
Pre Hospital - PCP - Primary Care Paramedic (Certificate)
Pre Hospital - ACP - Advanced Care Paramedic (Licensed)
Pre Hospital - ACP - Advanced Care Paramedic (Certificate)
Pre Hospital - CCP - Critical Care Paramedic (Licensed)
Pre Hospital - CCP - Critical Care Paramedic (Certificate)
Other
Secondary Certification Expiration
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
Additional Certification Type
Please Select
Athletic Trainer
Chiropractor
Dispatch / Communications
Festival Health / Harm Reduction
First Aid - SFA - Standard First Aid
First Aid - OFA 1 - Occupational First Aid Level 1
First Aid - EFA - Emergency First Aid
First Aid - National Lifeguard
First Aid - Certified Rescue Diver
First Aid - EFR - Emergency First Responder
First Aid - AMFR - Advanced Medical First Responder
First Aid - CSP - Canadian Ski Patrol
First Aid - OFA 2 - Occupational First Aid Level 2
First Aid - OFA 3 - Occupational First Aid Level 3
First Aid - CPR only
First Aid - WFA - Wilderness First Aid Logistics
MD - Attending
MD - Attending - Anaesthesia
MD - Attending - CASEM
MD - Attending - Critical Care
MD - Attending - Emergency Medicine
MD - Attending - Family Medicine
MD - Resident - Yr 1
MD - Resident - Yr 2
MD - Resident - Yr 3
MD - Resident - Yr 4
MD - Resident - Yr 5
MD - Student - Yr 1
MD - Student - Yr 2
MD - Student - Yr 3
MD - Student - Yr 4
Medical Office Assistant / Clerk
ND - Naturopathic Doctor
Nursing - LPN - Licensed Practical Nurse
Nursing - RPN - Registered Practical Nurse
Nursing - RPN - Registered Psychiatric Nurse
Nursing - RN - Registered Nurse
Nursing - NP - Nurse Practitioner
Nursing - Student Yr 1
Nursing - Student Yr 2
Nursing - Student Yr 3
Nursing - Student Yr 4
RT - Respiratory Therapist
RT - Student - Y1
RT - Student - Y2
RT - Student - Y3
Physicians Assistant - PA
Physiotherapist
Pre Hospital - Student (Paramedic)
Pre Hospital - Fire Fighting Professional
Pre Hospital - AEMCA (Ontario only)
Pre Hospital - EMR - Emergency Medical Responder (Licensed)
Pre Hospital - EMR - Emergency Medical Responder (Certificate)
Pre Hospital - PCP - Primary Care Paramedic (Licensed)
Pre Hospital - PCP - Primary Care Paramedic (Certificate)
Pre Hospital - ACP - Advanced Care Paramedic (Licensed)
Pre Hospital - ACP - Advanced Care Paramedic (Certificate)
Pre Hospital - CCP - Critical Care Paramedic (Licensed)
Pre Hospital - CCP - Critical Care Paramedic (Certificate)
Other
Additional Certification Expiration
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
Emergency Contact
Emergency Contact
Emergency Phone
Emergency Contact Relationship
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