MMI Volunteer Application

Thank you for your interest in volunteering with Hospitals for Humanity on an upcoming Medical Mission Initiative. All fields in the application are required.

Basic information

First name

Last name

Email

Phone number

Street address

Street address continued

City

State/Province

Zip/Postal code

Country

How did you hear about Hospitals for Humanities and our Medical Mission Initiatives?
 Web search Media/News story Facebook/YouTube Friend/Colleague

Professional information

Please select your profession
Phyisician
 Anesthesiologist Cardiologist Gynecologist/Obstetrician Internal Medicine Ophthalmologist Otolaryngologist (ENT) Pediatrics Surgeon
Other specialist
 Optometrist Podiatrist
Dentistry
 General dentist Oral and Maxillofacial Surgeon
Mid-level
 Nurse Practitioner (NP) Physician Assistant (PA) Certified Registered Nurse Anesthetist (CRNA) Anesthesiologist Assistant (AA)
Nurse
 Registered Nurse (RN) Licensed Practical Nurse (LPN) Certified Nursing Assistant (CNA)
Pharmacy
 Pharmacist
Technicians
 CT Dental EMT Medical Laboratory MRI Ophthalmic OR Perfusionist Pharmancy Surgical Ultrasound X-Ray

Job title

Current job description

Languages spoken

Please upload your résumé or CV
(Accepted file types include text, pdf, doc, and jpg.)

Emergency contacts










Essay questions

A Creole-speaking patient at an MMI clinic is in dire need of medical attention.
Her clinical signs are shortness of breath, head trauma and bleeding from a
head laceration. What will you do?

A patient at an MMI clinic has labored breathing. Our facility has oxygen
but no means of supplying the patient with it (nasal cannulas or masks).
What will you do?

In 300 words or less, tell us why we should select you.