Lisa: You are going to love your 2nd visit to CN. We leave next Saturday for our 3rd trip and can't wait.
I would think you would need a refresher but you can e-mail Karl at email@example.com and ask. Also...if you are over 50 (like us) we complete the PADI medical form for every trip and get it signed off by our own doctor. I heard of a guy who said "yes" to taking medications as he was taking something for Athlete's foot and they made him pay $50 US to have a Jamaican doctor come and check him out.
Better to do this all at home before you arrive.
Couples Negril - September 2011, 2012, 2013 and have just booked 2014
Scuba Club Cozumel - Jan, Apr & Nov 2012 and Jan & Nov 2013
Cobalt Coast, Grand Cayman - May 2013
Retiring & moving to Cozumel, Mexico in early 2014