Make a Difference Today.
Complete the quick form below to register to volunteer with Operation Sight:
Who are you registering to volunteer?
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I am registering myself as a volunteer surgeon.
I am an administrator registering doctor(s) on their behalf. I have the legal power to sign the Volunteer Agreement on their behalf.
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To volunteer with Operation Sight, volunteer surgeons must be practicing ophthalmologists, licensed to practice in the United States:
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I confirm that I am a practicing ophthalmologist and able to practice in the United States.
To volunteer with Operation Sight, volunteer surgeons must be practicing ophthalmologists, licensed to practice in the United States:
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I confirm that I am registering only ophthalmologist(s) able to practice in the United States.
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Volunteer Full Name, Degree
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First Name
Middle Initial
Last Name
Degree
Practice Point of Contact: Full Name
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First Name
Last Name
Volunteer Email
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You will receive an automatic email with "next steps" after completion of the registration form.
Practice Point of Contact Email
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You will receive an automatic email with "next steps" after completion of the registration form and registered volunteer surgeons will receive a welcome email.
Practice Name
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Please enter your practice's name as it should be listed for recognition purposes.
Practice Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please list all volunteer surgeon(s) that will be participating with Operation Sight below (enter surgeon full name and degree as they should be listed for recognition purposes).
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Volunteer Surgeon
Full Name, Title(s)
Email Address
Volunteer Surgeon 1
Volunteer Surgeon 2
Volunteer Surgeon 3
Volunteer Surgeon 4
Volunteer Surgeon 5
Volunteer Surgeon 6
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Operation Sight Volunteer Agreement
We ask all volunteers to review and sign our Volunteer Agreement recognizing the responsibilities and requirements of an Operation Sight volunteer. Please click the PDF document below to review this document. After this document has been reviewed and signed, please complete your registration by submitting your form below.
Important Note for Administrators:
If an administrator has the legal authority to sign on behalf of their doctors, they may do so. In all other cases, each individual volunteer must sign the form. Please click the PDF below to download and review our Volunteer Agreement.
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Does your practice own its surgery center?
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Full Ownership
Partial Ownership
No Ownership
Is your practice or organization a current Operation Sight grantee?
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Yes
No
Does your practice or organization currently hold 501c(3) status or have an affiliation with a 501c(3)?
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Yes
No
How did you hear about Operation Sight?
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ASCRS Foundation- Website, Blog Post, Email, Twitter
ASCRS - Website, Email, Social Media, ASCRS This Week
ASOA - Website, Email, Social Media, EyeMail
A Current Volunteer
Other
Signature
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