Thank you for your interest in volunteering with RAM!

This is a new registration system as of 2016, so if you made a volunteer account prior to that, please go ahead and make a new account.

This site serves: 1) to sign up new volunteers and 2) to allow registered volunteers to sign up for more clinics or change their assignments.

Your information will not be saved until you go to the very end of the page and click SAVE AND SUBMIT.

If your plans have changed, please use the RECALL MY INFORMATION button to pull up your assignments, and cancel yourself promptly.

 
      If you previously registered on this webpage, we will recall your information.
Do not RECALL your information and type over it for another family member. That overlays the existing record.
 
 
Abbreviated Title   Example: Mr., Ms., Dr., Hon.
 
     
Professional Abbreviations       Example: DDS, MD, PhD
Name on Badge       List the information you want to appear on your badge.
Example: Dr. Jeff, Ms.King, Sam
 
 
  If possible, we would like to text you with occasional reminders and pertinent updates.
Mailing Address Line 1   Include apartment, suite or box number, if applicable.
Mailing Address Line 2  
 
 
 
  We recommend an email address unique to the registered volunteer instead of a shared office address or the personal address of a group leader for all group members. We will send personalized scheduling correspondence to this address.
 
        
  Establish your unique User Name. You may use your email address as your User Name unless another registered volunteer will be receiving correspondence at that same address. 
        
  Used to recall your information when you visit this site again so you can make changes and/or select additional volunteer opportunities.  Your password must be at least 6 characters.
 
       
Required Age
  I will be at least 14 years of age when I volunteer. Volunteers under 18 must email volunteers@ramusa.org for the RAM Minor Release Form.
  For legal reasons these are the age restrictions for volunteering.
 
T-Shirt Size   T-Shirt style is adult unisex.
Language Fluency (other than English)
Select all that apply
  Hold down the control key to select more than one language.
Hold down the control key and click on a selected language to de-select it.
         
Other Information
    Do you have a CDL Truck Driver's License?    
    Pilot's License, Certifications, and Experience
    Please list any flight certifications, as well as hours/experience in each type of aircraft you are able to fly. Optional, indicate any aircraft you own. Additionally, please include any aircraft you own and would be willing to fly for RAM.
    Blood Borne Pathogen Certified     Have you taken an OSHA-approved blood-borne pathogen certification training?
    Vaccinated for Hepatitis B    
    Interested in deploying for disaster relief missions?     Check this box and we will send you more information shortly.
    Interested in volunteering for international clinics?
    If you are interested in doing medical clinics in other countries, please check this box and include any relevant information in the box below.
          
Company / Organization   Optional, but helpful to know especially if you're coming with an office or team.
Matching
My company has a matching program
  Please indicate if your employer matches your donated time with a financial donation to the non-profit where you volunteer.
Description   Describe the program requirements and let us know how we can help - provide information for anyone we must contact and/or list any documentation you might need etc.
 
First and Last Name  
Your Relationship to Contact    
Phone    
   
Event Area
  Select the area appropriate to your profession / classification.
Profession / Classification
General Notes
(if needed)
 
License Number   Enter "none" if a license is optional for your profession and you do not have a license.  Set the Expiration Date in the future.
Expiration Date    
Prof. Liability Insurance Carrier   Professional liability insurance is your responsibility. Write "NONE" if you do not have any.
State of Licensure   Out-of-state providers MUST follow the procedures for out of state volunteers.

Only U.S. licensed professionals are able to volunteer as healthcare providers.

License Comment   List additional information we should know. Examples: You selected Other Professional - indicate field/specialty. Your license will renew before the clinic. You are licensed in a second field - provide license details.
     
Residency Location  
Residency Supervisor  
     

We welcome student participation at our clinics! We have three main types of student participation:

  1. Pre-Health: If you are in a pre-healthcare track (pre-med, pre-nursing, pre-dentistry, etc.), please select "General Support" as your assignment.
  2. In Professional School - No Supervisor: If you are in medical, nursing, dental, etc. school (congrats on that!) yet you do not have a licensed faculty supervisor accompanying you to the clinic, that's okay! You are welcome to sign up for your respective field's "Support" category. (i.e. Dental Support, Vision Support, Medical Support). This will allow you to help and assist the professionals in that clinic area. Please fill out your school's information below.
  3. In Professional School - Supervised: If you are in medical, nursing, dental, etc. school (seriously, great job!) and you do have licensed faculty that will accompany you to the clinic - great! This means if you are in the right year of your program (typically if you are well into clinical rotations), then you will be able to practice patient care under your faculty's supervision. However, that supervisor must contact us at: orianeleake@ramusa.org. It is the only way to get approved. Once you have been approved, you will be able to select a Student assignment that will show up as your student type and your university ("Nursing Student - University of Tennessee"). Please fill out your school's information below.
School    
Field of Study / Degree Program    
Year of Study    
Onsite Faculty Supervisor    
       
 
Event
  Signing up for more than one clinic?

Great! Finish your registration and pick your assignments for your first clinic, then click

SAVE AND SUBMIT at the bottom.

THEN, click the RECALL button at the top to pull up your record, scroll down, and pick your assignments for the second event (and repeat).

 
Event Location
---
  More detailed directions will be available prior to your arrival.
Event Email
---
  Please add this information to your safe senders/callers list.
Event Phone
---
 
Event Information
 
 
Please select an assignment for each day you plan to attend.

- Waiting Lists: if your preferred assignment is full, a waiting list option may be shown. If you choose to be on the waiting list for your preferred assignment, you will also be given the option to select an alternate assignment. If an opening becomes available in your preferred assignment, you will receive an email notice (and, if selected, a text message) automatically moving you to your preferred assignment. This will automatically cancel you from the alternate assignment.

    
Admin Code
For administrative or instructed use only.
Day Type Assignment
   
     
   
Remote Area Medical thanks you for volunteering. Each volunteer is required to read and sign this Volunteer Agreement and Liability Waiver as a condition of participating in the event.

CONFIDENTIALITY STATEMENT

I understand that while I am participating as a registered volunteer at the Remote Area Medical clinic, it is mandatory that I maintain complete privacy and confidentiality of all patients. This pertains to all present and future written and verbal communications referring to any Remote Area Medical clinic patient. I also understand that unless I am obtaining information strictly for patient registration, I DO NOT ASK a patient any questions regarding medical insurance coverage, Medicare, or Medicaid. With my signature on the line below, I acknowledge that I have read, understand, and agree to adhere to this policy of confidentiality for the Remote Area Medical clinic.

RELEASE AND INDEMNIFICATION

I hereby release and indemnify Remote Area Medical, a non-profit organization, and all its respective officers, directors, agents, contractors, heirs, successors, and assigns, from prosecution or presentation of any claim for bodily injury or death or for property loss or damage incurred in connection with this Remote Area Medical expedition or related activities. I fully understand that I am volunteering at my own risk and that due to my occupational/other possible exposure to blood or other potentially infectious materials, I may be at risk of acquiring Hepatitis B virus (HBV) infection or other blood borne pathogens. I understand if I do not have the HBV vaccine, I continue to be at risk for acquiring HBV, a serious disease. If, in the future, I want to be vaccinated with HBV vaccine, I can acquire the vaccination at my own expense.

Sign in the space below:
Please use your mouse to sign on a PC or use your mobile device touch screen
 
Thank you for registering as a volunteer. Upon clicking the SAVE AND SUBMIT button, you will be emailed a confirmation of your registration/updates.
   


        
       
   
       
Software built by The SPARK Team, LLC
Contact us to find out more about Spark volunteer systems.
Your organization can be registering volunteers with this software in two weeks!
    The SPARK Team