City of Los Angeles Emergency Medical Corps - COVID-19
The City of Los Angeles has a need for medical professionals to support a surge in medical cases across Los Angeles due to the COVID-19 pandemic.

If you are a medical professional and would like to offer support (pro bono or paid) in response to COVID-19, please complete the below form. If you are selected for consideration, verification of your training may be required.
Email address *
Contact Information
Confirm Email Address *
Your answer
First Name *
Your answer
Last Name *
Your answer
Primary Phone Number *
Your answer
Secondary Phone Number
Your answer
I am 18 years + *
What type of Medical Professional Are you?
Are you a Medical Doctor? *
If you are a Medical Doctor, what is your specialty:
I am a different type of Medical Professional:
Do you have experience with specific populations:
Are you currently practicing?
Your answer
Potential Availability: *
Required
Days Available *
Required
Times Available *
Required
What languages do you speak/sign? *
Required
Are you part of a population potentially more vulnerable to being infected with COVID-19? (e.g., 60+)
Are you interested in offering your services pro bono? *
Are you already a DSW (Disaster Service Worker) or DSW Volunteer?
Other skills, notes, things you'd like us to know:
Your answer
A copy of your responses will be emailed to the address you provided.
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