MedicalMobilizers.org
Medical Disaster Relief
"Mobilizing Medical Professionals"
Director: Ron Lively, M.Div.,
M.A.
Office: 615-591-6969 Cell:
615-238-4035
www.medicalmobilizers.org
GOAL:
Create a master Medical
Disaster Relief Database
This is being done to
be of value for this disaster relief work and any
possible future disasters.
The goal is to is to do this in conjunction
with the local hospitals, clinics, churches and
other related organizations to help all of the
organizations in need of medical volunteers and
especially the local work of the American Red
Cross as they seek to provide the necessary
medical care of the evacuees.
Our sense is that this will be valuable
information since this is a long term project
after the initial interest diminishes.
We aim to appropriately share this data as
needed so that there is an effective centralized
mobilization process.
We appreciate your help to get this
database developed.
Volunteer
Licensed Medical Professionals Needed
Please submit this completed
form to the address above or email same
information to:
Ron@medicalmobilizers.org
Name_______________________________________________Degree:____________
Address:_______________________________________________________________
City:________________________________St: ___ Zip:________________________
Email: ____________________________________Best Ph#_____________________
Employed by:_________________________________as a _______________________
How can you best be of service?_____________________________________________
Most likely times you can volunteer?__________________________________________
Where would you like to serve?______________________________________________
Your suggestions/comments/needs: