THIS FORM IS FOR THE DATES 5/2-5/8. Requests are collected on a weekly basis. Please fill this form out by 4/29 at 5pm (or at your earliest convenience) to ensure enough time to adequately match you with the student volunteer.

As a small token of our appreciation for your strength and resilience during this incredibly trying time, we medical students want to help you however we can! *All services are free of charge*

After you complete this form, our amazing group of coordinators will connect you with current medical students who are eager to help out our dedicated healthcare workers any way they can. Once we receive your response, we will connect you via cell phone number to a specific medical student who has volunteered to help.

Please note, our volunteers are students with required didactics and off-site duties. Due to this, they can assist you best if you give specified dates/times. Our form opens every Monday afternoon to collect requests for the following week.

PLEASE READ: If you or anyone in your household meets any of the following criteria, we are unable to partner with you at this time and we apologize:

- Experienced a fever in the past 2 weeks
- Experienced shortness of breath in the past 2 weeks
- If you had contact with anyone diagnosed with COVID-19 without PPE
- Are not fully immunized (standard + current influenza immunization)

Created by: Shivam Shah, Angie Jacob & Jass Kaur