Volunteer or Observation Request Form » Department of Anesthesiology » College of Medicine

To begin the process, you must first attain a faculty sponsor and determine a time period. If you do not already have a faculty sponsor, please email Mary Brown, mbrown@anest.ufl.edu, for a list of faculty who accept volunteers and observers.

Volunteers must upload 5 documents with this form

Confidentiality Statement
Certificate of completion for “HIPAA & Privacy – General Awareness” or “HIPAA for Researchers” (only if involved in human research activities)
Emergency contact form
copy of your driver’s license (Gator1 card or passport if foreign national)
Record of volunteer service forms

Observers must upload 3 documents with this form

If you are unable to access the online form, please contact Mary Brown at mbrown@anest.ufl.edu for volunteering/observing assistance.

Volunteer or Observer Request Form

I am requesting to be a*
- Volunteer
- Patient Care Observer
The following faculty member is sponsoring me*
If you do not already have a faculty sponsor, please email Mary Brown, mbrown@anest.ufl.edu, for a list of faculty who accept volunteers and observers.
Contact Information
Name*
First Last
Email*
Phone
Current Occupation*
Name of current institution, school, or employer*
Address of current institution, school, or employer*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are you a UF student, staff or faculty?*
- Yes
- No
Requirements
Please upload completed files*
All - Confidentiality statement, HIPAA training certificate; Observers - patient care observation form
Drop files here or
CAPTCHA

Volunteer or Observer Request Form

Contact Information

Requirements