COVID-19 Assistance Pet Care Volunteer Form

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Thank you for signing up to be a pet care volunteer! Please acknowledge the following prior to signing up:

By signing up to volunteer, you are acknowledging/complying with the following guidelines:

1. You have not tested positive for COVID-19 or have been symptom-free for at least 14 days
2. You are not currently sick with a fever, cough, or sore throat
3. You have not traveled to a high-risk area (Washington, CA, NY, etc.) in the past 14 days
4. You are not in quarantine due to contact with a COVID-19 case
5. You are practicing social distancing (e.g. avoiding large groups)
6. You are acknowledging that you may be putting yourself at risk for contracting COVID-19 by working in the home of a healthcare professional
7. SLUSOM or the organizers of this volunteer program are not liable for any negative outcomes related to volunteering

If your answers to the above change at any time, you must contact your volunteer organizer!

Name *

School Email (.edu) *

Phone Number *

Affiliation *

SLU School of Medicine

Wash U School of Medicine

SLU Graduate Student

SLU Undergraduate

Other:

Are you willing to care for dogs? *

Yes

Other:

Are you willing to care for cats? *

Yes

Other:

Are you willing to care for other animals? *

Yes

Are you comfortable giving medications? *

Yes

Can you host the pet at your home *

Yes

Yes- preferred

Can you travel to a health care worker's home to provide pet care? *

Yes

Yes- preferred

Zip Code of Residence *

General Availability/Details- Please note if you have pets *

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