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Volunteering with Southern Health

Mandatory field

COVID 19 Volunteer Application Form
Hello and thank you for your interest in applying to be a Southern Health Volunteer! 
At this time, the Government has advised that anyone with the specified Health conditions below must protect themselves by following the advice to stay at home. If any of the following apply to you, there is helpful information on the NHS website, please follow guidance at this time, but you will be signposted by completing the form below to additional ways of supporting vulnerable people in your community. 
• Aged 65 or older (regardless of medical conditions) 
• Have chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis 
• Have chronic heart disease, such as heart failure 
• Have chronic kidney disease 
• Have chronic liver disease, such as hepatitis 
• Have chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy 
• Have diabetes 
• Have problems with your spleen – for example, sickle cell disease or if you have had your spleen removed 
• Have a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy 
• Are seriously overweight (a body mass index (BMI) of 40 or above) 
• Have received an organ transplant and remain on on-going immunosuppression medication 
• Have cancer and you are undergoing active chemotherapy or radiotherapy 
• Have cancers of the blood or bone marrow such as leukemia at any stage of treatment 
• Have severe chest conditions such as cystic fibrosis or severe asthma (requiring hospital admissions or courses of steroid tablets) 
• Have severe diseases of body systems, such as severe kidney disease (dialysis) 
• Are currently pregnant 
Do you have any of the Health conditions specified in the list above?
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