Healthcare Worker Survey: Calgary Healthcare Students for Healthcare Workers
WHO: This form is intended for healthcare providers in the Calgary area looking for support with life tasks outside the wards including childcare/babysitting, grocery runs, pharmacy runs, pet care, general errands, etc. Please note that the only service available for those who are currently self-isolating or have sick family members is grocery delivery! We want to keep everyone safe and healthy. Please make it clear that you are under self-isolation and requiring this service in the form below.

WHAT: We will do our best to connect you with a current U of C medical student or nursing student who is able to help (and has childcare experience, if required). We want to support you as best we can during this challenging time. Please note that this initiative is NOT affiliated with the Faculty of Medicine; it is a self-organized, student-led effort which originated in Toronto. We will be coordinating students independently from the medical school. This is an entirely volunteer based initiative and we discourage any compensation.

HOW IT WORKS: After you submit this form, we will review the list of medical students/nursing students who have signed up to help with various tasks. If we are able to find a suitable match, we will connect you and the student via text/email, after which you can arrange plans as schedules allow. We will match one student to one family so that we aren't inadvertently broadening our social circles through this initiative. Unfortunately, this may mean limited student availability. If we are unable to connect you with a medical/nursing student, we will let you know as soon as we can.

This initiative is entirely student-organized, but we do have approval from the UME. It is dependent on student availability, and the nature of the initiative may change as the COVID situation evolves. We ask that both students and providers ensure timely responses to each other and respect each others' limitations during this challenging time. For questions or concerns, please contact Brielle Cram (brielle.cram1@ucalgary.ca) or Moss Bruton Joe (moss.brutonjoe@ucalgary.ca)
What is your name?
Your answer
What is your email address?
Your answer
What is your phone number?
Your answer
Preferred contact method
What is your healthcare profession?
Your answer
Are you or any family members currently under self isolation?
In what area of the city are you located?
What services do you require help with?
IF you have requested pet or child care, please share additional details here. Specific points of interest: how many children do you have? Do they have any unique needs/considerations? Any allergies/dietary restrictions? Please be as detailed as possible.
Your answer
IF you have requested pet or child care, what specific tasks would you like the student to help with? Please be as detailed as possible (students are unable to transport people in their vehicles).
Your answer
What days do you require help?
What times of day do you require help?
How urgently do you need this service?
Your answer
Any additional comments/thoughts so that we can make the best student connection for you?
Your answer
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