FEMA COVID VACCINATION VOLUNTEER SURVEY

FEMA asked APhA to help them identify pharmacists, pharmacy technicians, and student pharmacists to help with their COVID-19 vaccination efforts. They are looking for volunteers who would be willing to travel to states that have requested FEMA assistance with administering vaccines. FEMA will cover the costs of transportation, lodging, per diem, other specified expenses . Volunteers can be both active practitioners or retirees with authority to immunize . They are looking for individuals who can to commitments for timespans of 14-60 consecutive days. Volunteers should be able to deploy with at least 48 hours notice.

At this point, FEMA is interested in determining whether there are pharmacists, technicians, or students who are interested in volunteering. If you are willing to volunteer, can you please complete take the attached short survey by Tuesday, February 16, 2021.

Filling out this survey does not commit you in participating and it does not guarantee that you will be working with FEMA.

I am a *

I have the following immunization credentials *

Completed a pharmacist - pharmacy-based immunization certificate training program

Completed a pharmacy technician vaccine administration program

Other Other

Level of interest

I am interested in working with FEMA at a vaccination site and understand that FEMA arranges for my travel, lodging, per diem, and other specified expenses. FEMA can follow up with me.

First Name *

Last Name *

Address *

Address 2

City *

State/Province *

Zip/Postal Code *

Phone *

Email Address *

Preferred way to contact *

Phone

Email

Any