Volunteer Health Profile Form

1. Introduction
Thank you for your willingness to volunteer with Nomads of Hope, Inc. To help ensure your safety, well-being, and appropriate placement during your volunteer service, and to allow us to respond effectively in case of an emergency, we ask you to provide certain health-related information. This form collects personal and potentially sensitive health information. These Terms & Conditions govern the collection, use, storage, and disclosure of the Health Information you provide.
2. Purpose of Collection
Nomads of Hope, Inc collects your Health Information solely for the following purposes:
* To understand any health conditions, allergies, or physical limitations that may affect your ability to safely perform certain volunteer tasks.
* To identify any necessary accommodations or adjustments we might reasonably make to support your volunteer role.
* To have relevant information readily available to assist you or provide to emergency responders in the event of a medical emergency during your volunteer service.
* To maintain accurate emergency contact information.
* To assess overall suitability for specific volunteer roles requiring certain physical or health standards (clearly defined for the role).
3. Consent to Provide Information
By completing and submitting this Volunteer Health Profile form, you:
* Voluntarily consent to provide the requested Health Information to Nomads of Hope, Inc.
* Acknowledge that providing this information is a condition for certain volunteer roles or activities to ensure safety and suitability. You understand that you may choose not to provide certain information, but this may limit the volunteer opportunities available to you.
4. Accuracy and Updates
You declare that the information you provide on this form is true, accurate, and complete to the best of your knowledge. You agree to promptly inform Nomads of Hope, Inc's designated contact: Linda Shorette, the Project Coordinator at shorettelw@gmail.com of any significant changes to your health status, medications, allergies, or emergency contact details that may be relevant to your volunteer role or safety.
5. Use of Information
Your Health Information will be used by Nomads of Hope, Inc strictly for the purposes outlined in Section 2. It will primarily be accessed by Linda Shorette, the Project Coordinator, relevant program managers, designated first aid/emergency personnel on a need-to-know basis.
6. Confidentiality and Data Security
Nomads of Hope, Inc is committed to protecting the privacy and confidentiality of your Health Information. We will:
* Implement reasonable administrative, technical, and physical safeguards to protect your Health Information against unauthorized access, disclosure, alteration, or destruction.
* Limit access to your Health Information to authorized personnel who require it for the purposes stated above.
* Store the information securely (e.g., encrypted digital storage, locked physical files).
* Comply with applicable data protection and privacy laws relevant to our operations in Ecuador
7. Disclosure of Information
Your Health Information will be kept confidential and will not be disclosed to third parties except in the following limited circumstances:
* To emergency services personnel (e.g., paramedics, hospital staff) if required during a medical emergency involving you.
* If required by law, court order, or other legal process.
* With your explicit written consent for a specific purpose not covered here.
8. Data Retention
Your Health Information will be retained by Nomads of Hope, Inc for the duration of your active volunteer service and for a reasonable period afterward as required for administrative purposes or as mandated by law or our internal data retention policy. After this period, your Health Information will be securely destroyed or anonymized.
9. Your Rights
Subject to applicable laws, you have the right to:
* Request access to the Health Information Nomads of Hope, Inc holds about you.
* Request correction of any inaccurate or incomplete Health Information.
* Request the deletion of your Health Information (subject to legal or operational retention requirements).
* Withdraw your consent for the processing of your Health Information, understanding this may affect your ability to continue volunteering in certain capacities.
To exercise these rights, please contact Linda Shorette, the Project Coordinator at shorettelw@gmail.com.
10. Disclaimer and Limitation of Liability
* The collection of this Health Information does not constitute medical advice or diagnosis by Nomads of Hope, Inc. We are not a healthcare provider.
* Nomads of Hope, Inc relies on the accuracy and completeness of the information you provide. We are not liable for any injury, illness, or adverse event arising from inaccurate, incomplete, or outdated information provided by you.
* You acknowledge that volunteering activities may involve inherent risks, and providing this health information does not eliminate those risks, nor does it guarantee that Nomads of Hope, Inc can prevent all health-related incidents.
11. Emergency Contact Consent
By providing emergency contact information, you confirm that you have obtained the consent of your emergency contact(s) for Nomads of Hope, Inc to hold their details and contact them in the event of an emergency involving you. You also consent to Nomads of Hope, Inc contacting them and sharing relevant information (including necessary Health Information) in such an emergency situation.
12. Acceptance
By checking the box above and submitting this form you confirm that:
* You have read, understood, and agree to these Terms & Conditions.
* You consent to the collection, use, storage, and disclosure of your Health Information by Nomads of Hope, Inc as described herein.
* The information you are providing is accurate and complete to the best of your knowledge.