Kingwood Emergency Hospital CPR Group Request Form
Thank you for your interest in booking a dedicated CPR class for your business, school or organization.

Please note the following information:

While there is not a charge to take CPR with Kingwood Emergency Hospital, we employ the services of a local EMS company to teach the class. Classes for groups must be a guaranteed minimum of 5 attendees and not more than 10 attendees. If the class does not have at least 5 registrants 24 hours before the class, it may be cancelled.

It is the responsibility of the business, school or organization to solicit enrollment using the registration link we will provide to you. All participants must have an email address as the cards are transmitted to the participant via email. Class participants must enroll individually and provide contact data.

Classes are booked a minimum of one month in advance. Please be sure the dates you select are at minimum 30 days from the date of your request. Example: Requested date = Today's date + (30+) days.

The earliest time a class can start is 9 am
The latest time a class can start is 3 pm Mon-Thursday
The latest time a class can start on Friday is 1pm
Due to the demand for CPR - please allow 14 business days between this request and the requested class date.

A calendar invite and map are included with a completed registration.
A reminder notice is sent to registrants 24 hours before class.

If you have questions or need additional assistance, please call our Marketing Director at (832) 777-6165

Thank you!

Email address *
Today's Date *
MM
/
DD
/
YYYY
Name of Organization, School or Company *
Your answer
Address of organization *
Your answer
Zip code of organization *
Your answer
Contact First Name *
Your answer
Contact Last Name *
Your answer
Phone Number *
Your answer
Type of Class Requested *
Number of Expected Participants (Min 8, Max 12) *
Your answer
Class Date Requested (Monday-Friday) *
MM
/
DD
/
YYYY
Alternate Class Date Requested (Monday-Friday) *
MM
/
DD
/
YYYY
Start Time Requested *
Time
:
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.