You will be eligible to receive donated units and probes to be left with your in-country partner, if you: Have assessed oximetry needs in the OR and recovery area of your partner facility. * Can provide training on their use in addition to your patient care responsibilities. * Can provide an in-country contact at the facility accepting responsibility for the units. * Will provide feedback in the future on how to most effectively implement this initiative. * Trip Date *
Date Format: MM slash DD slash YYYY
* To be eligible, you must have an upcoming medical trip.
Destination Country * Afghanistan Albania Algeria American Samoa Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo, Democratic Republic of the Congo, Republic of the Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faroe Islands Fiji Finland France French Polynesia Gabon Gambia Georgia Germany Ghana Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Sudan, South Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Health Care Provider First Name *
* HCP must be personally traveling to the destination country, account for the disposition of the donated products, possess current U.S. license to practice and prescribe independently.
Health Care Provider Last Name * Health Care Provider Email Address *
Primary Contact First Name (optional)
* If different than Health Care Provider
Primary Contact Last Name (optional) Primary Contact Email Address (optional) In-Country Facility * In-Country Contact Name *
*The person who will accept responsibility for the pulse oximeters.
In-Country Contact Email Address * Quantity of Pulse Oximeters Requesting * Select One 1 2 3 4 5 Lifebox, the pulse oximeter manufacturer, is making an ongoing effort to improve their training materials. Please click on the AGREE button if you consent to allow Americares to share your contact information with Lifebox so that they can contact you for feedback related to the oximeter training materials. * As part of the Safe Surgery Initiative, Americares will be contacting the in-country contact regarding the use of the oximeters and Lifebox may reach out to them to follow up on the devices as well.
By selecting the "Submit" button, you are confirming that you have reached out to the in-country recipient and have their permission to share their contact information to both Americares and Lifebox. Thank you. We are grateful for your cooperation and excited about working with you.