NSRN Volunteer Task Inquiries: Hospital, Departments & Organizations

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On behalf of the National Student Response Network (NSRN), we want to first and foremost thank you for the efforts you put forth in our communities to keep us safe during this time.

The NSRN aims to field the volunteer needs of hospitals and public health departments and match them with nearby health professions students who are eager to help their communities. Once connected, your institution will be able to formally onboard our volunteers to your institution's standards.

**If you have a task for which you would like us to connect you with volunteers from our health professions student network, please complete the form below. We will be in touch as soon as possible.**

If you have any questions, comments and/or concerns, please email your state coordinator(s) or nsrn.health@gmail.com. You can also visit our website at nsrnhealth.org for more information.

Please select which of the following best describes your inquiry. *

My institution currently has a task (or tasks) for which we need volunteers.

My institution does not have a specific task right now but may need volunteers for future tasks. Please add us to your email roster and reach out again in the future.

Other:

I. CONTACT INFORMATION

Name of person completing this form *

Your affiliation to your institution (i.e. position, role) *

Email Address (will be used as primary form of contact) *

Phone Number

II. INSTITUTION INFORMATION

Which of the following categories best describes your institution? *

Hospital Department

Clinic

Other healthcare provider

State Public Health Agency

Local Public Health Agency

Non-Profit Organization

Other Volunteer-based Organization

Other:

Name of your institution (hospital, department and/or organization) *

Institution Full Address

Institution State *

Institution 5-digit Zip Code *

Institution County Name *

I understand that NSRN does not provide materials nor other equipment for volunteer tasks. All necessary materials and/or other equipment must be provided by the institution. *

I understand and agree.

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