Thank you for your interest in volunteering with RAM!

For information on how the coronavirus pandemic is influencing normal dental, medical, and vision clinic operations visit: https://www.ramusa.org/clinic-schedule/

If you are interested in volunteering at a COVID-19 drive-through testing site, please proceed in completing a volunteer profile!

Be sure to select “yes” when asked if you are interested in volunteering at a COVID-19 testing site.

Upon completion, make sure to scroll to the bottom and click "SAVE AND SUBMIT" otherwise your information will not be received.

We are currently staffing a COVID-19 drive-through site in Louisville, KY.

From here you can sign up as a volunteer, register for events, and change your assignments.

 
      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.  Note that t-shirts may not be provided at all events.
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
    Are you interested in volunteering at a COVID-19 testing site?    
 
   Please tell us which organization referred you to Remote Area Medical (RAM) for helping with the COVID-19 testing?
  Please check "YES" to acknowledge that you understand that you are responsible for the costs associated with volunteering including transportation and lodging.     
  Please check "YES" to acknowledge that you understand the following: You should NOT volunteer if you or someone you live with is over the age of 65; experiencing any health issues like diabetes, heart disease (including hypertension), lung disease or immunosuppression; not feeling well or has a fever; nursing or pregnant; or infected with Coronavirus.     
   
    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 infection control/ blood-borne pathogen certification training?
    Vaccinated for Hepatitis B    
    Are you an employee of the federal government?     Check yes if you are employed by the US federal government directly.
 
   Please select the area of the federal government.
    
   
    Interested in deploying for disaster relief missions?     Check this box if you would like to receive more information in the event that RAM needs people to deploy for a disaster.
    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.
    Interested in traveling within the United States for clinics?     If you are willing to travel to clinics further away from you but still within the United States please check this box.
          
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  
Relationship    
Phone    
   
Event Area
  Select the event 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 malpractice insurance is your responsibility. Write "NONE" if you do not have any and reach out to RAM to learn more about being added to our insurance plan.
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. Since you are not a licensed medical professional, we could use your help as a General Support volunteer where your tasks may range from helping in patient registration to dental sterilization, depending on your interests and our needs at the clinic. We are excited for your to get some volunteer experience with us!
  2. In Professional School - No Supervisor Present: If you are in medical, nursing, dental, etc. school yet you do not have a licensed faculty supervisor accompanying you to the clinic, you will not be able to practice patient care at the RAM clinic. This means you will not be able to provide any medical services or treatments to our patients. 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 assist the professionals in that clinic area by helping with patient flow, serving as a scribe to the licensed professional, etc. This is a great opportunity for your to gain shadowing experience or talk to professionals in the field you are studying while also helping the RAM clinic to run smoothly. Please fill out your school's information below.
  3. In Professional School - Supervisor Present: If you are in medical, nursing, dental, etc. school and you do have a licensed faculty supervisor that will accompany you to the clinic and if you are at least over halfway finished with your program and 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: volunteers@ramusa.org This is how our Volunteer Coordinators will provide the correct information, discuss the requirements, and approve your school for a specific clinic. 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    
       
 
Limit Event List by State?   Select a state to limit the list to only events in that state.
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
   
     
   
Select your profile picture   You may optionally upload a profile image. Just skip this option if you do not care to share an image. We accept GIF, JPG, and PNG images.
Your current picture
   
If you have been directed to upload a document of some kind please do so below. This is otherwise not necessary.
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Document 2 Name      
Document 3 Name      

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If you are volunteering at a Remote Area Medical event or clinic the following release and waiver language applies:

I hereby release and indemnify Remote Area Medical®, a non-profit organization, and all its respective officers, directors, agents, contractors, employees, heirs, successors and assigns from any claim for bodily injury or death or for property loss or damage incurred in connection with Remote Area Medical®, its missions or related activities. I also release and indemnify RAM for any claims against RAM by others as a result of my actions or inactions while volunteering for RAM, whether those actions are intentional or in negligence, and whether civil or criminal in nature. I fully understand that I am volunteering at my own risk regardless of the environment or services I am voluntarily performing for RAM. Additionally, but without limitation, I specifically release and indemnify RAM in relation to:

1. Any volunteer service I engage in which exposes me to blood or other potentially infectious materials putting me at risk of acquiring Hepatitis B virus (HBV) infection or other blood borne pathogens. I understand that if I do not have the HBV vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If, in the future, I want to be vaccinated with Hepatitis B vaccine, I can acquire the vaccination at my own expense; and,

2. The working environment at the RAM location where I volunteer which may take place near or involve working with or on heavy equipment and/or machinery, livestock, toxic materials, dangerous, and other potentially high risk activities.

I further hereby grant to RAM and its employees, directors, officers, agents, providers, and sponsors the right to use my picture, voice, or other reproductions of my physical likeness in connection with any advertising, publicizing or activities by RAM or any of its sponsors or Providers, in all media form, in perpetuity.

===============================================================

If you are volunteering at a COVID-19 medical testing site the following release and waiver language applies:

The undersigned, for him/herself, his/her personal representatives, guardians, heirs, and next of kin (hereafter, “Volunteer”) acknowledges, agrees, represents, covenants, and promises the following:

1. Administrative Services. In coordination with federal, state, and local governments, pursuant to the Public Readiness and Emergency Preparedness Act (“PREP Act”), and in furtherance of humanitarian efforts to provide emergency relief to the public and increase access to testing for SARS-CoV-2, Walmart Inc. (“Walmart”) is making available certain testing sites to increase public access to SARS-CoV-2 (commonly and hereafter referred to as “COVID-19”) testing. In furtherance of this effort, Volunteer desires to volunteer his/her time in an administrative and non-medical capacity to assist Walmart in its efforts to provide healthcare screenings and testing for COVID-19 at (the “Testing Site”). VOLUNTEER UNDERSTANDS THAT VOLUNTEER IS NOT PERMITTED TO PROVIDE THE HEALTHCARE SCREENINGS OR TESTING FOR COVID-19 AND AGREES TO ONLY PERFORM ADMINISTRATIVE TASKS HEREUNDER. In performing administrative services hereunder, Volunteer shall perform such services in accordance with all federal and state laws, rules, regulations, including the guidelines of the Centers for Disease Control and Prevention and the World Health Organization; and the bylaws, rules, regulations and policies of Walmart. Walmart retains the exclusive right to remove Volunteer from the Testing Site in its sole and absolute discretion at any time.

2. No Compensation. Volunteer understands and agrees that Volunteer will not receive compensation from Walmart for his/her efforts hereunder. Further, Volunteer agrees that (i) Volunteer is performing his/her services in an emergency relief capacity for humanitarian objectives, without contemplation or receipt of compensation and is not considered an employee of Walmart due compensation under the Fair Labor Standards Act; (ii) Walmart has not required or coerced Volunteer to perform the services offered hereunder; and (iii) while performing services under this Agreement, Volunteer is under the limited direction, supervision and control of Walmart. Volunteer shall not represent to any person that Volunteer is an employee of Walmart, and if asked by a patient or patient’s representative regarding Volunteer’s relationship to Walmart, will make known to the patient or patient’s representative Volunteer’s status as a volunteer.

3. Records. All records which are generated in connection with Volunteer’s services hereunder shall belong to and remain the property of Walmart or the appropriate federal or state government entity to which Walmart directs Volunteer to submit the records while at the Testing Site. Volunteer shall comply with the Health Insurance Portability and Accountability Act of 1996 and shall keep confidential patient health records and patient information.

4. Exposure; Waiver and Release of Liability. Volunteer is entering into this Agreement knowingly and without being coerced. Volunteer acknowledges that COVID-19 is a highly contagious novel virus that has been linked to deaths in individuals worldwide.

VOLUNTEER UNDERSTANDS AND ACKNOWLEDGES THAT HE/SHE IS VOLUNTEERING AT TESTING SITE WHERE IT IS HIGHLY PROBABLE THAT VOLUNTEER WILL BE EXPOSED TO AND COME INTO CONTACT WITH SICK INDIVIDUALS, INCLUDING INDIVIDUALS WHO MAY HAVE COVID-19 AND THAT VOLUNTEER MAY CONTRACT COVID-19 OR OTHER POTENTIALLY CONTAGIOUS VIRUSES. VOLUNTEER IS AWARE OF THE RISKS AND DANGERS INHERENT IN VOLUNTEERING AT THE TESTING SITE AND EXPRESSLY, VOLUNTARILY AND KNOWINGLY ASSUMES ANY AND ALL RISKS ASSOCIATED WITH VOLUNTEERING AT THE TESTING SITE INCLUDING EXPOSURES TO COVID-19 AND ANY MEDICAL COSTS OF VOLUNTEER.

VOLUNTEER EXPRESSLY WAIVES, FOREVER RELEASES AND DISCHARGES WALMART, ITS SUBSIDIARIES, AFFILIATES, DIRECTORS, OFFICERS, EMPLOYEES AND AGENTS FROM ANY LIABILITY, CLAIM OR CAUSE OF ACTION FOR ANY ADVERSE CONSEQUENCES THAT VOLUNTEER MAY EXPERIENCE ARISING FROM VOLUNTEER’S SERVICES HEREUNDER OR ANY VIRAL EXPOSURE, INCLUDING FOR ILLNESS, DEATH

OR DISABILITY.

5. PREP Act. In response to the national emergency posed by COVID-19, the Secretary of Health and Human Services (“HHS”) issued a Notice of Declaration under the Public Readiness and Emergency Preparedness Act (“PREP Act”) for medical countermeasures against COVID-19 dated February 4, 2020 (the “Declaration”). The Declaration immunizes “Covered Persons” under the PREP Act, which includes companies and volunteers working in collaboration with federal, state, or local governmental agencies with respect to the covered countermeasures. Among the Covered Persons afforded immunity under the PREP Act is a person or entity that provides a “facility” (such as the Testing Site) that is used to administer or use a Covered Countermeasure (such as COVID-19 tests or drugs to treat individuals with COVID-19) in accordance with a declaration by the Secretary of HHS. Given Volunteer’s role as a volunteer at the Testing Site, Volunteer’s actions may be covered by the PREP Act for liability immunity as a covered person aiding Walmart in providing covered countermeasures under the PREP Act.

6. Indemnification and Hold Harmless. Notwithstanding Section 5 above, Volunteer shall indemnify, defend and hold harmless Walmart and its officers, directors, employees, and agents from and against any liability, claims, damages, costs, fines, penalties, losses or expenses incurred by or imposed upon them arising out of Volunteer’s performance of services which constitute willful misconduct or gross negligence at the Testing Site. Furthermore, notwithstanding Section 5 above, Volunteer shall hold harmless Walmart and its officers, directors, employees, and agents from and against any liability, claims, damages, costs, fines, penalties, losses or expenses incurred by or imposed upon them arising out of Volunteer’s exposures to COVID-19 or other exposures inherent in providing the Services at the Testing Site.

7. Term and Termination. This Agreement shall commence on the Effective Date and continue until Volunteer ceases volunteering at the Testing Site.

8. Governing Law. The Agreement shall be governed by and construed in accordance with the laws of the State of Arkansas, excluding, however, the Arkansas conflict of law provisions.

9. Binding on Successors and Assigns. This Agreement shall be binding upon and inure to the benefit of Walmart and Volunteer and their respective heirs, personal representatives, successors, and permitted assigns.

My signature below acknowledges my understanding of and agreement with the above release and indemnification and constitutes my waiver of all possible claims against RAM as well as those of any other persons or entities which could or may act or make claims on my behalf including, but not limited to, my attorneys, heirs, successors, agents, employees and other third parties, for any actions or claims that are or that may arise as a result of my service as a volunteer for RAM.

Sign in the space below:
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Thank you for registering as a volunteer. Upon clicking the SAVE AND SUBMIT button, you will be emailed a confirmation of your registration/updates.
   


        
       
   
       
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