Riverside County hospitals are facing an unprecedented surge of patients needing care which is overloading our local healthcare system.

In the coming days/weeks we are asking ALL physicians (active, retired, residents), medical students, PA, NP, RN, LVN and MA to rise to the challenge and volunteer their time and talent to our impacted communities across Riverside County regardless of specialty.

RCMA is assembling a list of volunteer staff to deploy directly to Riverside County hospitals in need. Even though you may have previously signed up to help through the Riverside County or the California state volunteer system, please complete this survey and update your availability.

HOW WILL YOUR DATA BE USED?
Your survey data will be accessed by a small group of designated Riverside County Hospital HR personnel to identify potential needed staff. You will be contacted directly by hospitals in need of help.

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Designation (MD/DO, PA, NP, Resident, Medical Student, RN, LVN, MA)

Question Title

* 4. Contact Email Addres

Question Title

* 5. Contact Phone Number

Question Title

* 6. Home or Practice City

Question Title

* 7. Age?

Question Title

* 8. Medical Specialty

Question Title

* 9. Are you currently in active practice or working in a medical practice? (Yes, No, Retired)

Question Title

* 10. License Number (If Applicable)

Question Title

* 11. License Expiration Date (If Applicable)

Question Title

* 12. Do you have Medical Professional Liability Insurance?

Question Title

* 13. Are you looking to be paid?

Question Title

* 14. Preferred volunteer region:

Question Title

* 15. Volunteer Availability:

Question Title

* 16. Volunteer Hours:

T