Thank you for volunteering your time to support doctors and health professionals in India during COVID-19. Please complete this form to help us coordinate your interest with the need in India.

Volunteers should be aware that participating in this program may expose you to distressing information. Should you require assistance or support please contact support services in your local area / state. Some support options are linked below.

 

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The information on this form is being collected by the College of Health & Medicine, Australian National University (ANU). The information is being collected, with your consent, in order to complete your registration for the ‘Global Mentorship & Support program for COVID Health Professionals’ initiative. The information will be used by authorised staff for the purpose for which it was collected, and any other purpose which you have expressly consented to. You can withdraw your registration any time by contacting jay.poria [at] anu.edu.au. If you do not provide all the information that is requested on this form, it may not be possible for us to ensure appropriate arrangements for your participation in this initiative.

The ANU is committed to protecting personal information provided by you in accordance with the Privacy Act 1988 (Cth) and the information will be protected against unauthorised access and use.

All information collected by the University is governed by the ANU Privacy Policy.

For further information about how the University deals with personal information, please refer to the ANU Privacy Policy or contact the ANU Privacy Officer at privacy@anu.edu.au.

You may access or request correction of any personal information you have provided to ANU by contacting privacy@anu.edu.au.

Disclaimer

  • neither the university nor the remote peer assume any responsibility for patient care by participating in the program, and that responsibility continues to reside with the treating healthcare professional in India;
  • if the healthcare professional in India needs their own healthcare or mental health assistance, it can only be provided by a proper provider in India and neither the university nor the remote peer can assume that responsibility; and
  • if the remote peer in Australia or elsewhere has health or mental health needs through participating in the program, they should contact support services in their local area / state. Some support options are linked to the Volunteer registration webpage.