Call2Care - Adult Intake
Call2Care is a telephone reassurance program that allows college students and adults to socialize, share knowledge, and provide friendship and mentorship to one another by telephone.

To become a Call2Care Adult or sign up a loved one for this service, complete the signup form below. Please note that you can skip any questions you wish except for your name, contact information, ethical behavior agreement, and county/state of residence.

For questions, please email call2care@georgiasouthern.edu or call us at (912) 478-8546.

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What is your/the Call2Care Adult's name? *
What is the name of the person completing this form? (If different than the Call2Care Adult, please leave a phone number or email).
What is your/the Call2Care Adult's phone number? *
Tell us a little about yourself/the Call2Care Adult.
What is your/the Call2Care Adult's birthday? (they can skip if they want)
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How did you/the Call2Care Adult hear about the Call2Care Program?
Would you/the Call2Care Adult also like to receive texts about the Call2Care Program?
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What county and state does the Call2Care Adult live in? *
In case of emergency, what is your address? This will only be used in the event that you need emergency assistance or other critical care.
Would you/the Call2Care Adult like us to have an emergency contact person we can call in the event that you cannot be reached? Please provide this person's  (1) Name, (2) Phone Number, and (3) Relationship to You
The following is the Call2Care Ethical Behavior Statement for adult participants. This statement is part of our efforts to ensure that everyone who participates in the Call2Care Program has a good experience. We ask that our Call2Care Adults: (1) Treat Call2Care Student Volunteers and others with respect. (2) Maintain respect and value for cultural differences and differences of opinion.  (3) Avoid derogatory, harmful, discriminatory, and damaging statements on the basis of race, color, ethnicity, nationality, age, sexual orientation, ability, religion, spirituality, social status, and any other characteristic of those you encounter. (3) Update the Call2Care Team about any problems, changes, or positive things that arise during your time in the program.  Does the Call2Care Adult agree to these conditions? *
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