Saba Foundation for Rare Diseases (SFRD)

Section A: Personal Information & Demographics

Provide your basic demographic details and emergency contacts. These are required to establish your profile as an active volunteer.

First Name *

Last Name *

Date of Birth *

Age

Gender *

Primary Email Address *

Mobile / WhatsApp Number *

Communication Address

State *

City *

Full Address *

Pincode *

Social Media Handles *

Add links to your primary social channels. At least one handle is required.

Nationality *

Languages Spoken *

EnglishHindiUrduTeluguTamilKannadaMalayalamMarathiBengaliGujratiPunjabiKashmiriOthers

Your Current Medical Condition, if any like Allergies, Injuries etc which are important to be known by SFRD

Emergency Contact Person *

Contact Name *

Relationship *

Contact Number *

Email ID *

Section B: Professional Profile

Your professional background helps us place you in roles matching your skills and experience.

Occupation *

Qualifications & Certifications Checklist

Highest Qualification

Professional Certifications

Section C: Skills & Expertise

Identify your skills and tools that could assist the foundation in patient navigation and advocacy.

Skills *

CounselingPublic SpeakingTeachingDigital LiteracyHome CareWheelchair AssistanceGovernment DocumentationInsurance GuidanceData CollectionSurvey AdministrationEvent ManagementVolunteer CoordinationPatient NavigationCommunity OutreachSocial MediaFundraisingDocumentationFree taggingOthers

Digital Tools / IT Skills *

MS OfficeAccountingDigital MarketingMobile AppsAI ToolsCRMEMRLMSTelemedicine

Section D: Ready to Volunteer As

Tell us how you would like to participate and how much time you are ready to spend.

Volunteering Category *

Patient IdentifierPatient NavigatorCaregiver TrainerEducation VolunteerTechnology MentorDisability Rights AdvocateFundraising VolunteerCommunity MobilizerHome Care VolunteerTransportation VolunteerTranslation VolunteerPsychological Support Volunteer (if appropriately qualified)Employment MentorResearch VolunteerRegistry VolunteerPolicy AdvocateEvent ManagementContent CreatorSocial Media InfluencerOthers

Preferred Mode of Volunteering *

PhysicalMobile/TelephoneVideoWhatsAppEmailOthers

Patient Support Group Preferences *

ChildrenAdultsWomenSenior CitizensTerminal CareNewly DiagnosedUndiagnosed PatientsDisabled PatientsLow-income FamiliesRemote VillagesOthers

Time/Availability Preferences *

WeekdaysWeekendsMorningAfternoonEveningOther timings

Are you willing to travel? *

YesNo

Section E: Your Rare Diseases Experience

Do you have any personal or professional experience with rare diseases? Tell us about it.

Your Personal Experience Category

PatientParentCaregiverSiblingNGO WorkerHealthcare ProfessionalResearcherOthers

Requires Orientation? *

YesNo

Number of Patients Supported previously *

Total Years of Rare Disease Experience *

Section F: Documentation Corner

Verify your identity, upload professional credentials, and sign the mandatory compliance consents.

Identity Proof *

Voter IDDriving LicensePAN CardAadhaar CardPassportRation CardGovernment IDPSU IDPensioner CardStudent ID CardBonafide Student CertificateDisability ID Card.

Address Proof *

Voter IDDriving LicensePAN CardAadhaar CardPassportGovernment IDPSU IDPensioner CardRecent Bills with date less than 3 months Electricity BillWater BillTelephone / Mobile BillGas Connection BillBank Account Statement

Document Uploads

Upload Identity Proof Document(s) *

Upload Address Proof Document(s) *

Upload Professional Certificates

Upload Employer Verification / No Objection Document

Upload Self Background Verification / Reference Letters

Criminal Background Disclosure (if any)

Legal Documents Checkboxes *

Signed NDACode of Conduct AcceptanceConflict of Interest DeclarationData Privacy Agreement

Compliance & Consent Statements *

I understand and acknowledge that my role as a volunteer for SFRD is entirely pro-bono (unpaid).I consent to SFRD securely storing the personal information I have provided in this form for coordination and communication.Confidentiality Agreement: I agree to maintain the strictest confidentiality of all patient and family information.I agree to represent the Saba Foundation for Rare Diseases in a positive and professional manner and adhere to the Volunteer Code of Conduct.I understand that failure to comply with any of these conditions may result in my exit from SFRD Volunteer Program.Photographs or videos taken of me on a site may be used by SFRD for promotional purposes.I will not smoke, consume or store alcohol or illicit drugs while working as a Volunteer on a site.I have notified SFRD of any relevant medical conditions and pre-existing injuries, and I consent to the Project/s of SFRD.By checking this box, I confirm that all the information provided is accurate to the best of my knowledge and I agree to the terms of this volunteer partnership.