Haiti Earthquake Physician Relief Volunteer Form
Haiti Earthquake Physician Relief Volunteer Form
Welcome to the AMA/NDLS™ Disaster Volunteer Physician Registry. The AMA intends to use the registry as a means to facilitate and coordinate the deployment of physicians willing to volunteer with federal and private sector response organizations to respond to the Haiti earthquake. Practicing physicians are eligible to register.
Please be aware that the health care infrastructure in Port-au-Prince and other areas affected by the Jan. 12 earthquake and subsequent aftershocks have suffered significant damage. Physicians must be prepared to provide care in a physically challenging, austere, resource-constrained environment. It is imperative that those involved in the relief effort be self-sufficient and are able to work independently. Not every physician who registers with the AMA’s volunteer registry will be deployed.
Please view an AMA webinar that can help you prepare to support the relief effort in Haiti. After watching the webinar, you should have a better understanding of the essential clinical and public health skills needed to manage individuals and populations affected by the earthquake. You also will want to address your professional liability coverage with the agency responsible for your deployment in connection with the disaster relief effort.
The information collected in this database is being used specifically for disaster response deployment to Haiti, but it may also be employed should future disasters occur around the world. The AMA may contact you with information about disaster response resources and updates on disaster preparedness medical education.
* Asterisk indicates required field
