• The Alaska Mission of Mercy Volunteer Service Agreement – please read, when you register you will acknowledge having read and agreeing to the terms of the Agreement
• The AKMOM Volunteer Registration link – click on the Volunteer Registration button below to register
Please make a note of your orientation time and make a valiant effort to meet with your section lead at the Dena’ina Center at the specified time and location. If you cannot make that orientation time you have two other options. The first is to arrive at the Dena’ina Center a ½ hour before your scheduled session and the section lead will give you an orientation at that time. The second is to come to the Dena’ina Center after 12 pm on Thursday and someone will give you the orientation on the hour and half hour. All volunteers must have an orientation. At the orientation you will be given a tour of the clinic, briefed on the emergency egress plan and other safety issues, and given an overview of your responsibilities. You can also read all of the section information on this page under protocols. Please take time to read these documents and become familiar with your responsibilities before coming to the Dena’ina Center. You will also pick up your t-shirt or scrub top and your name badge at the orientation. Only authorized volunteers with name badges and AKMOM shirts will be allowed on the clinic floor so please remember to wear them to your session(s).
The AKMOM registration site will close on Friday April 4th so the committee has time to put together registration packets, print name badges and place the final shirt/scrub order. If you have friends that are procrastinating please pass this information along.
Parking is free for all AKMOM volunteers from 10-13 April only if you follow the AKMOM Parking Protocol. You must bring in your parking ticket to be validated to receive free parking. We cannot reimburse you for parking if you forget your ticket. Click here for Parking Protocol.
On behalf of the Planning Committee and Department Leads I want to thank you for volunteering and we all look forward to seeing you on Thursday Evening, April 10,2014.
As a volunteer for the Alaska Mission of Mercy, I hereby agree to respect each patient’s rights to self-determination and confidentiality, to refrain from harming the patient, to promote the patient’s welfare, to treat people fairly, and to communicate truthfully.
I acknowledge and agree that the Alaska Dental Society (ADS), the Alaska Mission of Mercy (AKMOM) and the Alaska Dental Society Charitable Activities Fund (ADSCAF), hereinafter referred to as the “ENTITIES”, do not assume any responsibility whatsoever for any of my personal property and I shall not hold the ENTITIES liable for any loss or damage to the same.
In compliance with the HIPAA Privacy Act: I agree to hold in confidence all personal and protected health information that I may overhear or come in contact with prior to, during and following the Alaska Mission of Mercy project.
I also grant the ENTITIES and their agents the right to use, without payment or consideration of any kind, photographic, voice and other reproductions of my physical likeness, in connection with publicizing and/or advertising the ENTITIES’ activities and services in all forms of media, in perpetuity.
I understand that clinical providers rendering oral healthcare treatment services must have all the necessary, appropriate and active professional licenses issued by the appropriate licensing authorities and the requisite liability insurance to provide treatment to Alaska Mission of Mercy patients and that all volunteers must agree to a background check to participate in the AKMOM project. My acceptance of this AKMOM Volunteer Service Agreement gives explicit permission to the ENTITIES to verify my background and the status of my professional licenses.