National Nurses United

National Nurses United - Registered Nurse Response Network - For Haiti Medical Relief - Send Nurses Now

 

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Diverse Nurses

RNRN Haiti Relief

RNs Volunteer Here

Haiti RN Updates

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SEND A NURSE
to Haiti Today

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UNITED.org

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RNRN Disaster Relief Volunteer Form

Be there for patient care...

Thank you for signing up with the NNU RN Response Network in collaboration with the CNA/NNOC. Registering as a RNRN volunteer does not automatically mean you will be called for a disaster. RNs will be asked to volunteer based on need and availability.We are currently recruiting RN volunteers to provide relief in Haiti following a major earthquake 01/12/10. PLEASE JOIN US!

 Download & share the RNRN brochure


RNs complete this form to express interest in volunteering:

First name *
Last name *
Address *
City *
State/Province *
Zip/Postal Code *
Home Phone *
Cell Phone
Primary Email *
Are you a Registered Nurse?
RN License Number
Are you a Nurse Practitioner?
Hospital or Affiliation
(Name and Location)

Unit/Expertise * ER          
(Answer required for each) ICU         
PEDS      
PSYCH    
Unit/Expertise Other
CURRENT Specialties/Certifications *
(Answer required for each) PALS 
BLS    
CCRN
PHN   
Other Specialties/Certifications
Job Title or Classification

Experience & Travel:
Do you have disaster relief experience? *
Do you have a current passport? *
Availability:
(click the down arrow to select)
Other availability

Vaccinations:
Vaccination - Hepatitis A
Vaccination - Hepatitis B
Vaccination - Typhoid
Tetanus
You will also need Malaria Prophylaxis


Language:
Do you speak French? *
Do you speak Creole? *
What is your primary language? *
List other languages you speak?

Affiliations:

Are you a NNU member? *

Are you a CNA/NNOC member? *
Are you a member of RNRN? *

Indicates Required Fields *


Thank you!
Please wait to be contacted after submitting.
 

   


 Download the RNRN brochure and share it with others!

 
 
AFFILIATED ORGANIZATIONS


AFL-CIO
National Nurses United
National Nurses Organizing Committee
Massachusetts Nurses Association
Caregiver and Healthcare Employees Union
California Nurses Foundation
Registered Nurse Response Network (RNRN)

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