How to get started volunteering
Out of State Volunteer Forms
In order to facilitate your volunteer effort for St. Anna�s Medical Mission, following is a list of the forms and documentation required. To begin the process,simply download the Personal Information packet below, which must be comleted by everyone. MDs must download and complete the MP Packet for Licensure; Nurses must download and complete the Nurse Packet for Licensure. Please return the completed forms to:
St. Anna�s Medical Mission
1313 Esplanade Ave.
New Orleans, LA 70016
Attn: Diana Meyer
Or Fax them to: (504) 947-2122
Please allow a minimum of 2 weeks for verification of licensure before we can allow you to work with us. We will contact you as soon as the verification is complete to set dates / times for your work.
If you have further questions and would like to speak directly with someone from St. Anna�s Medical Mission, please call (504) 947-2121.
Personal Information Packet PDF download.
Forms Included in the Personal Information Packet:
• Out-of-State Volunteer Intake Form
• Volunteer Medical Information Form
• Out-of-State Conditions of Participation Form
• Episcopal Diocese of Louisiana � Volunteer Agreement & Release
• Liability Release and Indemnity Form � St. Anna�s Medical Mission
• Confidentiality Agreement
MD Packet for Licensure PDF download.
Nurse Packet for Licensure PDF download.
We can�t thank you enough for your willingness to work with us to serve the people of New Orleans.
Louisiana Good Samaritan Act -- LSA-R.S. 37:1731.
Gratuitous service at scene of emergency; limitation on liability
A. No physician or surgeon licensed under the provisions of Chapter 15 of this Title, or nurses licensed under the provisions of Chapter 11 of this Title who in good faith gratuitously renders emergency care or services at the scene of an emergency, except in a public or private hospital of this state, to a person or persons in need thereof shall be liable for any civil damages as a result of any act or omission by such person in rendering the care or services or as a result of any act or failure to act to provide or arrange for further medical treatment or care for the person involved in the said emergency.
B. Any physician, surgeon, or member of the medical profession who is not licensed to practice medicine in Louisiana but who holds a valid license to practice medicine in any other state of the United States who gratuitously renders care or services at the scene of an emergency as herein provided shall not be charged with violation of the Louisiana Medical Practice Act.
C. No veterinarian licensed under the provisions of Chapter 18 of this Title, who in good faith gratuitously renders emergency care or services or assistance at the scene of an emergency to an animal or animals in need thereof, shall be liable for any civil damages as a result of any act or omission by such person in rendering the care or services or assistance, or as a result of any act or failure to act to provide or arrange for further veterinary medical treatment or care for the animal involved in the said emergency.
D. No dentist licensed under the provisions of Chapter 9 of this Title, who in good faith gratuitously renders emergency care or services at the scene of an emergency, except in a licensed dentist office or public or private hospital, to a person or persons in need thereof shall be liable for any civil damages as a result of any act or omission by such person in rendering the care or services or as a result of any act or failure to act to provide or arrange for further dental care or treatment or care for the person involved in the emergency.
E. (1) No emergency medical technician who in good faith gratuitously renders emergency care or services at the scene of an emergency to a person or persons in need thereof shall be liable for any civil damages as a result of any act or omission in rendering the care or services or as a result of any act or failure to act to provide or arrange for further medical treatment or care for the person involved in the emergency. (2) For purposes of this Section, "emergency medical technician" means a certified first responder as defined in R.S. 40:1231(10) and a certified emergency medical technician as defined in R.S. 40:1231(3), (4), or (5).
(1988)