Registration Form

Name *
Academic profile
Please select all that apply
Language Proficiency
Please indicate which languages in which you would be comfortable reading, writing, giving lectures, and responding to questions
Please check any additional topics you could present:
Availability and flexibility
We know that the schedules and needs of our partners in Haiti are subject to change, and we understand that your schedule may have limitations. We will use this section to match opportunities in Haiti with Visiting Professors
Would you be able to be physically present in and volunteering in Haiti for:
Check all that apply
How much advanced notice would you need when an opportunity becomes available?
Previous International Experience
Please help us to understand your previous clinical or academic experience outside of the US/CAnada
Have you worked in a clinical or academic capacity outside of the US/Canada previously?
If multiple, list all
In days, weeks, or months
Commitment to the Vision
We envision a self-sustaining Haitian medical education system that is a source of pride for Haiti, equips Haitian health care professionals to provide high quality care to all Haitians, & is built on a foundation of equity and collaboration. We seek to create an atmosphere of bidirectional learning
Please review and check boxes as applicable to indicate that you are aware of our expectations and denote your ability to participate if invited *
-I am aware that I may be paired with a student or young professional in Haiti, and I will work in close partnership with them during my time in Haiti -I am aware that I will be responsible for financing my plane tickets to and from Haiti (if an international candidate) -I am aware that there is a $300 USD fee (for international professors), and with this fee I will be provided with simple room and board, and in-country transportation, a translator if needed, a stipend to my teaching assistant and basic photocopying if needed -If I am found to be a good match for a particular academic program and have significant financial difficulties that preclude my participation, I know that on an individual basis I can request financial assistance from EqualHealth and this request will be honored based on available resources -I am aware that housing/ room & board is not available for accompanying friends or family members

VP Costs

For each trip, the Visiting Professor Program and our partner sites incur costs from personnel time, room and board, as well as in-country travel arrangements. Donations to help offset these costs are welcome and deeply appreciated. You may make a donation online