Through guidance provided by ODP and Governor Wolf, Via is able to provide some direct care services to participants and provide assembly/manufacturing to support essential businesses.  If you are interested in volunteering to work during this time, please take a moment to answer the questions below to assess your risk level to provide these services.

The health and safety of our employees is our priority.  If you volunteer to work during this crisis, you will be equipped with precautions such as sanitizing products, gloves and soap.  You will need to continue to follow the regular disinfectant procedures to prevent infection of any kind.  All staff must limit social contact as much as possible and not hold group gatherings of more than 10 people.

Question Title

* 1. First & Last Name

Question Title

* 2. Cell Phone Number

Question Title

* 3. Email Address

Question Title

* 4. Department/Program

Question Title

* 5. Days Available to Work

Question Title

* 6. Do you live with someone (or are you yourself) at a higher risk for a serious illness? Including: Older Adults (60 years or older), people with heart disease, lung disease including asthma, diabetes, HIV, women who are pregnant.

Question Title

* 7. Have you traveled outside of the United States or been in close contact with anyone who has traveled outside of the United States within the last 14 days? 

Question Title

* 8. Have you had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days?

Question Title

* 9. Have you experienced any cold or flu-like symptoms in the last 14 days (fever, cough, shortness of breath or other respiratory problem)?

T