ST. ANNA'S MEDICAL MISSION

Volunteer Forms

Instructions for Out-of-State Volunteers:

ALL VOLUNTEERS must complete, sign and submit, as far in advance of your trip as possible to assure a spot for you, the following forms:
- OUT-OF-STATE Volunteer Info
- OUT-OF-STATE Releases
- NURSES: Also complete, sign and submit these forms as soon as possible:
  - Nurse Volunteer Form
- DOCTORS: Also complete these forms:
  - Physician Volunteer Form
- SOCIAL WORKERS:
  - Social Worker Volunteer Form
Send a legible copy of:
- A government issued photo ID (driver's license or passport)
- Health insurance card
- Proof of recent (within 1 year) TB skin test:
- Copy of current CPR card (nurses, doctors)
- Copy of your current Medical/nursing/social work License
- Copy of your DEA number (doctors only)
- Reference Letter re: your work and appropriateness for this Mission
- To:
  - Email: diana@stannanola.org
    Fax: (504) 947-2122
  - Mail: Diana Meyers
    1313 Esplanade Ave.
    New Orleans, La 70116

Please contact Celeste (504-232-4496) or Diana (504-947-2121) with questions. We can't thank you enough for your willingness to work with us to serve the people of New Orleans.

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ST. ANNA'S MEDICAL MISSION

Volunteer Forms

Instructions for Out-of-State Volunteers:

SAMM Links