Thank you for volunteering your time to support health professionals in India during CV-19. Please complete this short survey which will help us coordinate your interest with the need in India.
Thank you, the COVID Connect Team

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* 1. Name

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* 2. Contact (phone/mobile/email)

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* 3. Indian Languages spoken

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* 4. Medical Specialty and APHRA registration number (if registered)?

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* 5. Will you be interested in providing telehealth for home based care?

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* 6. Will you be interested in providing peer support to young health professionals?

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* 7. Will you be interested in doing well-being checks/ mentoring young health professionals?

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* 8. Where in Australia are you based?

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