Healthcare Workers for Afghan Refugees
Please provide your contact information if you are interested in receiving updates regarding volunteer work or work opportunities.

Are you a physician (any specialty), PA, nurse, NP, pharmacist, optometrist, dentist, mental health counselor or have any other healthcare related experience?

If you have any comments or questions, you may reach out to:

Afghan Medical Professionals Association of America @ AMPAA.USA@gmail.com

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Full Name *
Best Contact Number (Mobile) *
Can we text you? *
Primary Email Address *
What kind of healthcare worker are you? *
Are you a student, resident or fellow?
What is your specialty? *
Practice Setting *
Hospital Affiliation or Company *
Are you Afghan? *
Select any language(s) you are fluent in. *
Required
Which state do you live in? *
Select the state(s) where you are licensed. *
Required
Do you have a full-time job? *
If you have a full-time job, when are you mostly available? *
Required
Are you comfortable with providing consultations over the phone? *
Would you be interested in paid opportunities? *
Are you okay with your contact information being shared with other members in the healthcare community? [Patients will not have access to your direct contact information] *
If you are a healthcare provider, do you take medicaid?
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