VOLUNTEERS NEEDED AT PROSPECT HIGH SCHOOL

HeartSmart EKG needs approximately 75 volunteers on WEDNESDAY, FEBRUARY 12, 2020, to help run our cardiac screening program at Prospect High School.

HeartSmart EKGs relies on adult volunteers as our primary labor source. Parent volunteers are used to perform a small component of the EKG test, assist with student registration and processing. You do not need prior experience. You will be trained and supervised by medical staff. Believe it or not, it is easy and fun!

Training takes place on Tuesday, February 11th from 5:30 - 7:00 pm. Attendance at training is mandatory, however, several administrative positions are available for both shifts where training is not required.

Questions: Contact Kathy Aykroid, Kathy@HeartSmartEKG.org or 847-736-8140.
I would love to help! I have marked my calendar to attend training on: *
AND to volunteer for the following shift(s): *
Required
Name: *
Your answer
Gender: *
Mailing Street Address: *
Your answer
Mailing City: *
Your answer
Cell phone number: *
Your answer
Email: (All correspondence will be sent via email) *
Your answer
Any special skills? EMT, RN, MD
Your answer
HeartSmart EKG Confidentiality *
We assure the students and parents participating in the HeartSmart EKG screening protocol of their right to privacy of person and records according to the laws of confidentiality. We recognize that as providers of services and processors of medical patient records, we have a committment, an obligation, and a responsibility to protect their privacy of all information that we receive in the process. I understand that the performance of my volunteer work may directly, or indirectly, result in my gaining knowledge of confidential patient or organizational information. All medical, personal, or organization information, whether written, computerized, oral, or tangible in any other way is deemed confidential and will be treated as such. All users given access to information regarding participants in the HeartSmart EKG screening program will keep confidential all information made available to them regarding medical, demographic, and organizational data. I have read the position on confidentiality and security of participant information and I understand any violation, whether intentional or unintentional, may result in my immediate removal from the program.
I grant permission to use any photographs, recordings or any other record of this event for any legitimate purpose of the Max Schewitz Foundation. We will ask your permission again just before we allow permit photos. *
Legal Name: *
Your answer
Any additional information:
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy