Non-Medical volunteer interest form

Thank you for your interest in the Los Angeles County Emergency System for the Advance Registration of Volunteer Health Professionals (ESAR VHP). This is your opportunity to volunteer to help our community following a large scale disaster or other public health emergencies. Volunteers that pre-register and are accepted as Los Angeles County ESAR VHP volunteers can be deployed rapidly and effectively to help following the next disaster. We are committed to protecting the health and safety of our volunteers. In the event of a public health emergency, active volunteers and their families will receive any necessary preventative medication for that event prior to being deployed for volunteer service.

The Volunteer Center of Los Angeles (VCLA) is working in partnership with the Los Angeles County Department of Health Services, Emergency Medical Services Agency and Department of Public Health to provide assistance with volunteer registration and management. Registration is easy: Once you have submitted the interest form below, your information will be sent to VCLA. VCLA staff will email you a link to the ESAR VHP application.

Please note: The information we collect as a part of the volunteer registration and credentialing is stored on a highly secured system and will only be accessible to official representatives. Please be assured that your contact information will only be used to assist us in contacting you regarding trainings and emergency deployment. We do not sell, rent or otherwise share your personal information with any third parties. As required by the national ESAR VHP program, all potential volunteers are screened using the Federal Exclusion List.

Please answer the following questions, and if you answer ‘yes’ to all of them, fill out the form below.

  • Are you at least 18 years of age?
  • Are you an active or retired medical, health or mental health professional or other general volunteer?
  • Are you in good health? (Able to lift up to 25 lb and work in strenuous conditions including fluctuations in room temperatures, crowded and noisy environment, stress, etc.)
  • Are you fluent in English?
  • Are you willing to work long hours, if necessary?
  • Are you flexible and able to work in a team?
  • Are you willing to follow instructions?
Email Address:
First Name :
Last Name:
Middle Initial :
Date of Birth:
Ex. 00/00/00
Phone Number:
Ex. 818-123-3456
Profession:

I would like to be part of the Los Angeles County Medical Reserve Corps (MRC) (Includes medical, health, and all other non-medical volunteers for Point of Dispensing (POD) and other public health emergencies)

The MRC is a community-based organization and organizes medical, health, and all other non-medical individuals volunteering their time and expertise for public health emergencies.  Following a public health emergency, Los Angeles County may open numerous Points of Dispensing ( POD) sites which will be used to rapidly dispense medications or administer vaccinations to the affected population in LA County. Non-medical volunteers will assist in various roles that help to ensure PODs function smoothly. Medical knowledge is helpful, but not required for these roles. For more information on POD skills assessment and volunteer roles click here.

If you have any questions about this system or need further information about the ESAR VHP program, please call the LA County ESAR VHP hotline in the Volunteer Center of Los Angeles at (818) 908-5128 or email at er@vcla.net.

Thank you again for your interest. You will be contacted shortly.