Thank you for your interest in volunteering with RAM!
From here yous can sign up as a volunteer, annals for events, and modify your assignments.
If you lot previously registered on this webpage, we will call up your information. Do not Think your information and type over it for another family unit member. That overlays the existing record.
Abbreviated Title
Instance: Mr., Ms., Dr., Hon.
Professional Abbreviations
Example: DDS, MD, PhD
Engagement of Birth
required
Name on Badge
List the data you desire to appear on your badge. Instance: Dr. Jeff, Ms.King, Sam
If possible, nosotros would similar to text you with occasional reminders and pertinent updates.
Mailing Accost Line one
Include apartment, suite or box number, if applicable.
Mailing Address Line ii
Nosotros recommend an e-mail address unique to the registered volunteer instead of a shared office address or the personal address of a group leader for all group members. We will send personalized scheduling correspondence to this address.
Establish your unique User Name. You may use your email address as your User Name unless another registered volunteer will be receiving correspondence at that same address.
Used to think your information when y'all visit this site again and so you can make changes and/or select additional volunteer opportunities. Your password must be at least 8 characters and comprise at to the lowest degree one letter and one number. Information technology may non contain the characters < ' & * # .
Required Age
I will exist at least 14 years of historic period when I volunteer. Volunteers under 18 must email volunteers@ramusa.org for the RAM Small-scale Release Form.
For legal reasons these are the age restrictions for volunteering.
T-Shirt Size
T-Shirt style is developed unisex. Note that t-shirts may not be provided at all events.
Language Fluency (other than English) Select all that utilize
Hold down the control key to select more than i language. Hold down the command cardinal and click on a selected language to de-select it.
Other Information
Interested in volunteering to provide telehealth services?
If y'all are willing to volunteer to provide telehealth services through RAM delight cheque this box.
Are yous interested in volunteering with RAM telehealth services?
Delight provide your NPI number hither.
Please provide your DOB using MM//DD/YYYY format here.
Where did yous complete residency (listing multiple as needed)?
If y'all are licensed in whatever additional states, please provide license number, state, & expiration engagement.
Check "Yeah" that you acknowledge y'all must provide a profile moving picture below (this is the starting time image patients volition see) and upload a current cv.
Airplane pilot's License, Certifications, and Experience
Please list whatsoever flight certifications, as well as hours/experience in each blazon of aircraft you are able to fly. Optional, indicate whatever shipping you own. Additionally, please include whatever aircraft you lot ain and would be willing to fly for RAM.
Blood Borne Pathogen Certified
Accept yous taken an infection control/ blood-borne pathogen certification preparation?
Vaccinated for Hepatitis B
Are y'all an employee of the federal government?
Check yes if you are employed directly by the Usa federal government.
Delight select the area of the federal authorities.
If other, please specify.
Interested in deploying for disaster relief missions?
Check this box if you would like to receive more information in the event that RAM needs people to deploy for a disaster.
Interested in volunteering for international clinics?
If you are interested in doing medical clinics in other countries, please check this box and include any relevant information in the box beneath.
Interested in traveling within the United States for clinics?
If y'all are willing to travel to clinics further away from you simply still within the United States please bank check this box.
Company / Organisation
Optional, but helpful to know peculiarly if yous're coming with an office or team.
Matching
My company has a matching program
Please indicate if your employer matches your donated time with a fiscal donation to the non-profit where you lot volunteer.
Description
Depict the programme requirements and let united states know how nosotros can assistance - provide data for anyone we must contact and/or listing any documentation yous might need etc.
Showtime and Last Name
Relationship
Telephone
Event Surface area
Select the consequence expanse appropriate to your profession / classification.
Profession / Classification
General Notes (if needed)
License Number
Enter "none" if a license is optional for your profession and you do not take a license. Set the Expiration Date in the future.
Expiration Appointment
Prof. Liability Insurance Carrier
Professional person malpractice insurance is your responsibleness. Write "NONE" if you do not take whatsoever and achieve out to RAM to larn more about being added to our insurance plan.
State of Licensure
Out-of-country providers MUST follow the procedures for out of state volunteers.
Simply U.S. licensed professionals are able to volunteer equally healthcare providers.
License Comment
Listing additional information we should know. Examples: You selected Other Professional person - bespeak field/specialty. Your license volition renew earlier the dispensary. Yous are licensed in a second field - provide license details.
Residency Location
Residency Supervisor
We welcome student participation at our clinics! We take three chief types of educatee participation:
Pre-Health: If y'all are in a pre-healthcare runway (pre-med, pre-nursing, pre-dentistry, etc.), please select "General Back up" as your assignment. Since you lot are not a licensed medical professional person, we could use your assistance as a General Support volunteer where your tasks may range from helping in patient registration to dental sterilization, depending on your interests and our needs at the clinic. We are excited for your to get some volunteer feel with us!
In Professional School - No Supervisor Present: If you are in medical, nursing, dental, etc. school nonetheless you practise not take a licensed kinesthesia supervisor accompanying you to the clinic, y'all will not be able to practice patient intendance at the RAM clinic. This ways you will not exist able to provide any medical services or treatments to our patients. Y'all are welcome to sign up for your respective field's "Back up" category. (i.e. Dental Support, Vision Support, Medical Support). This will allow you to assist the professionals in that clinic surface area by helping with patient flow, serving as a scribe to the licensed professional, etc. This is a bully opportunity for your to gain shadowing feel or talk to professionals in the field you are studying while besides helping the RAM clinic to run smoothly. Please fill out your school's data below.
In Professional School - Supervisor Nowadays: If you are in medical, nursing, dental, etc. schoolhouse and you do have a licensed faculty supervisor that volition accompany you to the clinic and if you are at least over halfway finished with your program and well into clinical rotations, then you will be able to practice patient intendance nether your kinesthesia's supervision. However, that supervisor must contact us at: volunteers@ramusa.org This is how our Volunteer Coordinators will provide the correct information, discuss the requirements, and approve your school for a specific clinic. Once you have been approved, you volition be able to select a educatee assignment that will testify up as your student blazon and your academy ("Nursing Pupil - University of Tennessee"). Please fill out your schoolhouse's information below.
School
Field of Written report / Degree Program
Year of Report
Onsite Faculty Supervisor
Limit Event List by State?
Select a state to limit the list to only events in that state.
Outcome
Signing up for more than one clinic?
Great! Terminate your registration and pick your assignments for your first clinic, then click
SAVE AND SUBMIT at the lesser.
THEN, click the Retrieve button at the meridian to pull upwardly your record, scroll downwardly, and selection your assignments for the second event (and repeat).
Issue Location
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More detailed directions will be bachelor prior to your arrival.
Result Email
---
Delight add this information to your rubber senders/callers list.
Consequence Phone
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Event Information
Please select an assignment for each day yous plan to nourish.
- Waiting Lists: if your preferred assignment is full, a waiting list option may exist shown. If yous choose to be on the waiting list for your preferred assignment, you will likewise be given the option to select an alternate assignment. If an opening becomes available in your preferred assignment, yous volition receive an e-mail notice (and, if selected, a text message) automatically moving you lot to your preferred assignment. This volition automatically abolish y'all from the alternate consignment.
Admin Lawmaking
For administrative or instructed use only.
Select your profile moving-picture show
You may optionally upload a profile prototype. Just skip this option if you exercise not care to share an epitome. Nosotros accept GIF, JPG, and PNG images.
Your current picture
If you have been directed to upload a document of some kind please do and then below. This is otherwise not necessary.
Document 1 Proper noun
Document 2 Name
Document 3 Name
No files accept been uploaded
I hereby release and indemnify Remote Area Medical®, a non-turn a profit organisation, and all its respective officers, directors, agents, contractors, employees, heirs, successors and assigns from any merits for bodily injury or decease or for belongings loss or damage incurred in connection with Remote Area Medical®, its missions or related activities. I also release and indemnify RAM for any claims against RAM by others every bit a result of my deportment or inactions while volunteering for RAM, whether those deportment are intentional or in negligence, and whether ceremonious or criminal in nature. I fully empathise that I am volunteering at my ain risk regardless of the environment or services I am voluntarily performing for RAM. Additionally, but without limitation, I specifically release and indemnify RAM in relation to:
1. Any volunteer service I engage in which exposes me to claret or other potentially infectious materials putting me at take a chance of acquiring Hepatitis B virus (HBV) infection or other blood borne pathogens. I understand that if I do not have the HBV vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If, in the future, I want to be vaccinated with Hepatitis B vaccine, I can acquire the vaccination at my own expense; and,
2. The working surround at the RAM location where I volunteer which may take place near or involve working with or on heavy equipment and/or machinery, livestock, toxic materials, dangerous, and other potentially high take chances activities.
3. I further hereby grant to RAM and its employees, directors, officers, agents, providers, and sponsors the right to apply my picture, voice, or other reproductions of my concrete likeness in connection with any advertisement, publicizing or activities by RAM or any of its sponsors or Providers, in all media form, in perpetuity.
COVID-19 Pandemic Notice and Acknowledgement of Take chances
The Earth Wellness Organization has characterized the COVID-nineteen virus, also known every bit "Coronavirus," as a pandemic. RAM wants to ensure you are aware of the risks of exposure to COVID-19 associated with receiving treatment during this pandemic.
COVID-19 is highly contagious and has a long incubation period. Individuals may have the virus, not testify symptoms and even so nonetheless be highly contagious. COVID-nineteen can upshot in a life-threatening respiratory illness in some patients. You may be exposed to COVID-19 at any time or in any place. Due to the volume of individuals on site, the characteristics of the virus, and the characteristics of certain healthcare procedures, there is an elevated run a risk of you contracting the virus simply by existence at a RAM clinic.
Some procedures can create fine water spray or "aerosols" which may remain in the air for several minutes to hours. These aerosols may comprise the COVID-19 virus and may create a risk of COVID-19 exposure.
To provide a safe environment for our patients and staff, RAM follows the applicable state and federal regulations and protocols for infection command, universal personal protection, and disinfection. However, due to the nature of the procedures we provide, it may not be possible to maintain social distancing betwixt patients, doctors, and staff at all times. Additionally, some of the safety measures being taken by RAM to prevent the spread of COVID-19 have been known to trigger allergic reactions or may be sensitive to your optics or skin. Should you experience such during your presence in the RAM clinic, please notify a wellness care provider or other RAM professional volunteer.
My signature beneath acknowledges my agreement of and understanding with the above release and indemnification and constitutes my waiver of all possible claims against RAM besides as those of any other persons or entities which could or may act or make claims on my behalf including, merely not limited to, my attorneys, heirs, successors, agents, employees and other tertiary parties, for any deportment or claims that are or that may arise as a result of my service every bit a volunteer for RAM.
Sign in the space below:
Delight use your mouse to sign on a PC or apply your mobile device bear upon screen
Thanks for registering every bit a volunteer. Upon clicking the SAVE AND SUBMIT push button, you will be emailed a confirmation of your registration/updates.
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