Queen's Healthcare Students for Healthcare Providers (Student Form)
WHAT:
Thank you for your interest in supporting our local healthcare staff! With all the demand being placed on the local system, QMed students would like to support healthcare providers and staff with their non-work responsibilities. These could not have been planned or budgeted for, and many healthcare workers have been left scrambling to find assistance. We may not be healthcare providers yet but we are trained to be leaders in our community and have the opportunity to help our colleagues.

HOW:
Sign-up below with your contact information and services you feel comfortable providing. We will connect you with healthcare staff shortly afterwards.

Our current policy is:
1) This is not officially affiliated with Queen's Medicine and is completely student-run. We're doing our best to help out staff but students assume liability of any assistance they provide.
2) For those in clinical years/placements, please do not sign up until 14 days have passed since your last day of clinical duties. We'll try to keep this service running as long as it's needed but we have to balance our offer to help with the risk it may pose to others.
3) Students who have traveled outside of Canada or been in close contact with travelers from outside of Canada should refrain from volunteering.
4) Each student should only volunteer with one family to minimize the risk of transmission.
5) Only students with childcare experience should volunteer to provide childcare.
6) Please take extra measures to wash your hands, monitor yourselves and those around you for symptoms, and to practice physical distancing as much as the volunteering you provide allows. Some of the help you provide may involve interacting with young children, older folks, or those who are at higher risk of becoming sick. Let's be proactive with supporting those who need it while mitigating the risks as much as we can.

We are open to other suggestions on how to maintain safety and social distancing. Please note that by signing up, you acknowledge that you have read and accepted the conditions of the following agreement: https://drive.google.com/file/d/11CAaXuxVo3_eJkXA00Dvmw5OO8ATZ2a8/view?usp=sharing

Disclaimer: This is a student-run initiative that will be occurring off-campus and has no affiliation with the university. There may be changes based on student availability and as the nature of the COVID situation evolves. Please ensure timely communication between students and providers, and respect each others' limitations during this difficult time.
Full name
Your answer
Email address
Your answer
Phone number
Your answer
Preferred communication method
Program
Class
For clerks and those on clinical placements, when was your last day of clinical duties?
Your answer
Please list days and times that you are available to help.
For example: March 16th (all day), March 17th (after 5pm), March 18th (all day)
Your answer
Do you have a vehicle that you're willing to use?
What childcare experience do you have (include ages)?
For example: babysitting kids age 3-7
Your answer
What assistance are you comfortable providing?
For example: childcare, pet care, pickups/dropoffs, errands, checking on seniors
Your answer
Would you be willing to help other community members (non-healthcare workers)? You'd be provided with more details before committing to help.
Do you have any additional considerations you would like us to know about?
Your answer
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