Volunteer Doctors Registration Form

Name *
Name
Address *
Address
How may we contact you?
Preferred Contact Method *
Agreement *
I agree that when acting as a volunteer doctor I must be able to respond to a patient file within 24hrs, or use out of office setting, provide responses that are realistic for the setting, and suggest either treatment, local investigations, or referral to next level of care. If appropriate, I will attach educational information to responses.