PR Medical Volunteers Form
Thank you for your interest in volunteering to help with the medical needs in Puerto Rico.
Please send copies of all certifications and credentials to FloridaSearchAndRescue@gmail.com
NOTE: Please be patient while we review your information as we are all volunteers. Please feel free to email us at FloridaSearchAndRescue@gmail.com for questions.
We will not sell or share your information, nor use it for purposes other than relief efforts in Puerto Rico.
Email address *
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Cell Phone *
Your answer
How soon are you available to travel? *
MM
/
DD
/
YYYY
What level of medical aid are you qualified to perform? (you will be required to send evidence) *
Do you have field trauma, emergency response or disaster recovery experience? *
Are you able find your own transportation to Ft Lauderdale Executive Airport (FXE)? *
Are you able to handle incredibly austere and chaotic/uncertain environments? *
Are willing to work within the organizational structure/follow chain of command? *
Comments/Questions
Your answer
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