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RWJMS Students for COVID-19 Response
Sign up here if you’re interested in supporting our healthcare staff by ensuring they are well-supported outside of the hospital.

Who should NOT sign up?
- Students who have had fever, dry cough, or shortness of breath anytime in the past 2 weeks.
- Students who have come into contact with anyone diagnosed with COVID-19.
- Students who are not up-to-date on vaccinations, including annual influenza.

For questions or concerns, feel free to reach out to the SGA Presidents: Sneha Swaminathan (, Vijay Putatunda (, Kavita Jain (, Chris Wachuku (
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Name (First name Last name) *
RWJMS E-mail Address *
Class Year *
Where do you live? *
You don’t have to provide a specific address at this time. Just an intersection/neighborhood can help us match you to requests that are closer to you.
How far are you willing to travel to provide support? (Select all that apply) *
We will do our best to match you to tasks that are closest to you. In the event that requests are made that are further away, we will reach out to students who indicate they are willing to travel.
Tasks that you are willing to do (select all that apply): *
What days of the week are you generally available to provide support? (Select all that apply)
What time of the day are you generally available to provide support? (Select all that apply) *
If there is a need for financial reimbursement, how are you able to receive reimbursement? (Select all that apply) *
Have you been all-symptom free for the past 14 days? *
Cough, fever, shortness of breath, sore throat, runny nose. **The same question is posed to every healthcare staff who requests help and will be asked again when you are connected with a healthcare staff**
Any Feedback?
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