SHOW 6th Annual Health Fair Preceptors Volunteer Registration

Email address *

Health Fair 2019

Saturday, November 2, 2019
10:00am - 2:00pm
Lodestar Day Resource Center
1125 W Jackson St, Phoenix, AZ 85007

First name *

Last name *

Phone number *

Have you volunteered with SHOW in the past? *

Yes

No

Other:

If not, have you submitted a preceptor application?

Yes

No, but I'm working on it! (tinyurl.com/SHOWPreceptorApp; please note that you must have all documentation on file with Tammy Krause, Tamara.M.Krause@asu.edu, before you can precept!)

Clear selection

University or Organization Affiliation *

Arizona State University

The University of Arizona

Northern Arizona University

Midwestern University

A.T. Still University

Fortis College

N/A

Other:

Health Professional Discipline *

Audiology

Dental

Medicine (MD or DO)

Nurse Practitioner (ANP)

Nurse Practitioner (DNP)

Nursing (RN)

Occupational Therapy

Pharmacy

Physical Therapy

Physician Assistant

Psychiatric Mental Health Nurse Practitioner (PMHNP)

Recreational Therapy

Speech Pathology

Social Work

Other:

Please select all shifts you are able to volunteer: *

Shift 1: 9:30AM - 12:00PM

Shift 2: 11:30AM - 2:00PM

Required

Are you available to work multiple shifts?

If you check yes, we will only schedule volunteers in consecutive shifts i.e., you will not be scheduled with a gap in between shifts.

Yes

No

Clear selection

Booth Request

Please choose top 3 preferred booths.

Booth Choice #1 *

If you have a booth idea, please use the field "Other" and please send an email to Rebecca Chung (mchung13@asu.edu) so (space allowing) we can add your booth to this form! You will be provided with any materials you request -- please use the last question to let us know how we can support you!

Activities of Daily Living (address helping individuals develop a routine, work on their habits and fulfill the roles that are meaningful to them. We plan on doing this by providing a hygiene kit, a small planner and suggestions for planner apps available for download on their cell phones. We would also take the time to talk with each individual and educate them on ways to create good habits, routines, and ways that they can better fill their role of being a productive member of society)

Blood Glucose (This booth will offer to take the blood glucose of clients and provide education on factors that may affect blood glucose levels, recommended target blood glucose ranges, and tips on using blood glucose results to make decisions about possible diabetes care)

Blood Pressure (This booth will offer to take the blood pressure of clients and provide education on blood pressure and ways to monitor blood pressure through daily habits)

BMI Assessment (Volunteers will take clients' BMI. If patients have a high BMI, volunteers can refer them to other booths at the Health Fair. Additionally, provide education and resources about healthy lifestyles to prevent complications associated with high BMI)

Diabetic Neuropathy Screening (This booth will test for peripheral neuropathy and provide education on proper foot care)

Heart Health (education on managing stress, recognizing symptoms of a stroke and heart attack, and managing one's nutrition (cholesterol, weight, BP))

Leisure and Recreation (This booth is tailored to recreational therapy students to plan recreation activities aimed to reduce stress and build self-esteem of participants)

Nutrition (This booth will provide education on healthy eating. Some participants will be referred to this booth from other booths, such as diabetic neuropathy and BMI assessment, for further education tailored to the participant’s specific needs)

Sexual Health (educate on condom usage, STI symptoms, testing, and treatments, and connect clients to resources that provide STI testing and sexual health services)

Skin/ Breast/ Lung Cancer (Provide basic screenings for skin and/ or breast cancer and provide educational handouts. In addition, clients will be provided with questionnaires for lung cancer. There will be giveaways of sunscreens and chapsticks)

Social Work Booth (Listening booth along with a wallpaper for clients to write down some aspirations that mean something to them)

Posture, gait, and balance screening (Our booth will consist of giving gait (walking), posture, and balance evaluations and letting people know where their deficits and strengths are. They will then be given general stretching/treatment handouts to take with them to improve upon their deficits)

Depression/ Anxiety Screening

Other:

Booth Choice #2 *