MyImpactPage - DocTours Medical Volunteers

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Account

Username

Required

	Username must not start with space
	Username must not end with space
	Username must not have two or more spaces in a row

Password

Required

	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Confirm Password

Required

	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Name Fields

First Name Required
Last Name Required

Address

Address line 1 Required
Address line 2
City Required
Country Required
State / Province Required
Zip / Postal Code Required
Email Address Required

Phone Numbers

Required Please enter at least one phone number

Home Phone
Work Phone
Work Extension
Cell Phone
Phone Preference

Misc Fields

Region

About You:

Your Elective or Medical Volunteer Program

Country where you wish to visit? (First preference)

Country where you wish to visit? (Second preference)

Preferred department for your elective or volunteer program?

Your current profession? (ie Student, Doctor, Nurse, or ...?)

Requested role? ( eg Medical elective, Student Placement, Research, Practice, Teaching?)

Start Date

mm/dd/yyyy

Finish Date

mm/dd/yyyy

Duration of your elective or volunteer program (in weeks)?

Do you wish to be located with a friend(s)? Please advise their name(s).

Any other comments or preferences for your program(s)?

Personal Data

Details of any dietary requirements:

Details of any allergies or health concerns that may prevent you from performing certain kinds of work or in a certain work environment?

Level of travel experience to developing countries?

Any languages spoken (other than English)? Please provide details.

Preferred t-shirt size?

Where did you hear about DocTours?

Emergency Contact

Emergency contact name

Phone number and email address

Relationship to you?

Documents to upload - these documents can be uploaded later or forwarded to us separately.

** Please ensure that the page is fully saved after you upload any documents ** It may take a few moments for the 'Save' button to turn green again.

Resume / brief CV

Passport (copy of the photo page)

Letter of Good Standing - required for medical students

Digital photo (selfie)

Working with Children / Police Background Report

Any other documents that may be required

References

Name

Email and Phone Number

DocTours Terms and Conditions

DocTours Terms and Conditions - please read and agree to the T&C's

Required

Travel documents to upload. Please upload these documents when they are available.

Flight itinerary / e-ticket

Travel insurance details

Comments about your flights or insurance cover

Any other documents required.

Medical Registration / Visa documents (we will advise you on what is required for your destination).

Visa application (if required)

Registration Application Form (if required)

Any other documents required.

Foreign medical registration /licensing (if it is required, we will upload this certificate when it is ready. Please print this document and take it with you)

Foreign medical registration /licensing (please print this document and take it with you)

Your DocTours Information Pack (we will upload these documents 1 month prior to your departure)

Information Guide on your Destination

Contact Information and Orientation Sheet