Volunteer Sign up Form
We are thrilled to receive your support at the CKD screening event on Friday, May 10th at ExxonMobil YMCA (7717 Howell Blvd, Baton Rouge, LA 70807 ). With your support, we will provide participants rapid CKD assessments, identifying signs of kidney impairment and/or associated risk factors. In addition to on-site kidney result reviews, participants will have access to personalized educational sessions, CKD prevention materials, and resources to support their ongoing health journey. Thank you for being part of our volunteer team!
Full Name
First Name
Last Name
E-mail
example@example.com
Address
Street Address
Street Address Line 2
City
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Postal / Zip Code
Phone Number
Please indicate whether you are affiliated with any of thefollowing organizations:
YMCA
National Kidney Foundation
DaVita
Other
Job Title
List any medical certifications and/or degrees you hold.
Preferred Area to Volunteer:
Recruitment & promotion
Registration
Health testing
Health education
Medical consultations (providers only)
Line control & flow
This event needs volunteer support from 7 am to 3 pm. Please indicate your availability to volunteer.
7 am - 3 pm (full shift)
7 am - 11:45 am (only morning shift)
11:30 am - 3 pm (only afternoon shift)
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