Volunteer

Emergency Response Volunteer Form

Major emergencies can overwhelm the capabilities of first responders, particularly during the first 12 to 72 hours. Volunteers can provide an important "surge" capacity during this critical period. Communities often need volunteers to fill in the gaps in their emergency response plans and to improve their response capabilities overall.

Three Rivers Public Health Department (3RPHD) has implemented a volunteer registration system. 3RPHD will collect and store contact information on volunteers interested in filling response and recovery roles during and following a major public health emergency. Based on the information collected from each volunteer, public health officials will be able to identify those individuals willing to fill the specific volunteer roles needed in an emergency. Any personal contact information will remain confidential.

During an emergency event public health officials will generate a list of volunteers who may be contacted based on the information they provided. Those contacted will be given information on where to report and the option to accept or decline the opportunity. Registration does not obligate you to response however, by registering you may be contacted periodically to update your contact information and availability.

Please complete the form and then click submit at the bottom of the form to send your information to the Three Rivers Public Health Departments Emergency Response Coordinator.

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Three Rivers Public Health Department

2400 North Lincoln Avenue, Fremont, NE 68025  ~  402-727-5396 / 1-866-727-5396
Serving Dodge, Saunders & Washington Counties in Eastern Nebraska

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