Let's Get Healthy! from OHSU • Volunteer

First Name

Last Name

Email

City

State

Zip Code

Emergency Contact #1 NAME

Emergency Contact #1 PHONE NUMBER

Emergency Contact #2 NAME

Emergency Contact #2 PHONE NUMBER

We are trying to understand who volunteers with our program. Would you say that you are (select all that apply)...

Community member
Health professional
Already in desired career
Currently in school
Looking to go back to school

If you are not already in your desired career, how would you describe your career aspiration (select all that apply)?

Allied Health (physician assistant, radiology, dietetics, etc)
Nursing
Medicine (e.g. MD, DMD, DO, PharmD, etc)
Heatlh - other
Health - undecided
Non-health
Other
No answer

What is your age?

18 years old or older
Younger than 18 years old

Are you affiliated with Oregon Health & Science University (as a formal employee, student, volunteer, etc.)? NOTE: This does not include volunteering with the Let's Get Healthy! program.

Yes
No

How did you hear about "Let's Get Healthy!"?

Do you speak any other languages? You may check multiple boxes.

Spanish
Mandarin
Cantonese
Korean
Vietnamese
Other (please describe below)

For future reference, please tell us which area(s) you would be interested in volunteering at a Let's Get Healthy! event. We will notify you by email about upcoming events in the areas you check. You may check multiple boxes.

Any comments you'd like to share?

Volunteer

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