Reaching Out Participant Agreement (2023-24)
GWU Reaching Out is a program run by medical students at The George Washington University. This initiative aims to foster non-medical relationships between students and older adults in the greater DC community. As part of this program, older adults will receive calls from students to chat and connect.

Participation in this program involves the following:
  • You will be paired with a student, and the student will receive your name and phone number. No other personal information will be shared with the student.
  • You will receive calls from the student once or twice a month; you may indicate when and how often you prefer to be called in this form. 
Any information you share with your student during the calls will be kept confidential.

If you have any questions about the program, please email gwreachingout@gwu.edu!
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Email
Phone number  *
Age *
Pronouns
How did you hear about us?
How would you like to call? 
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Please select your time zone *
What time would you like to be called?
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How often would you like to receive calls?
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