JeContribue - Inscription

If you are authorized to administer screening tests or review results or lead investigations, please check the corresponding box in the “Your Contribution” section.

Anyone wishing to help regarding the situation related to the spread of COVID-19 is invited to complete the form.

If you are currently employed by a establishment in the health and social services network, contact your employer to provide your availability.

Some positions require experience or training in health and social services, but not all. In particular, that of the service assistant who performs general tasks such as cleaning, maintaining, storing the material and the equipment in use. He prepares and distributes certain products. He takes part in various living environment activities in which his contribution will focus on stimulation, supervision, accompaniment and verbal guidance for residents.

All fields marked with an asterisk (*) are mandatory.

Your contact details

First name

Last name

Telephone number

Home phone number

Cellular phone number

Email address

Postal code

Format: G1G 1G1

Do you have your Canadian citizenship? Yes No

Are you able to communicate in French? Yes No

Are you able to communicate in English? Yes No

Your contribution

To which group(s) do you wish to contribute? Dépistage COVID-19 (Être membre d’un ordre professionnel autorisé à effectuer ou à analyser des tests de dépistage)
Enquête COVID-19 (Habiletés à réaliser des enquêtes, professionnels de la santé, policiers, etc.)
Professionnel en soins (infirmière, infirmière auxiliaires, inhalothérapeute, préposé aux bénéficiaires, etc.)
Professionnel de la santé et services des sociaux (travailleur social, éducateur, psychologue, ergothérapeute, etc.)
Personnel administratif (agent administratif, technicien en administration, etc.)
Métiers (ouvrier en maintenance, préposé en hygiène salubrité, agent de sécurité, etc)
Sans formation en santé (aide de service)

Do you have a degree in the health field? Yes No

Specify the diploma obtained:

If a professional license is required, is it currently valid? Yes No

What is your practice number?

Work sector preference

Availability

What is your availability? (Every other weekend is required for most positions in the health and social services network) Day
Evening
Night
Weekend

From what date are you available?

How many days a week are you available?

Other information