SERVGA:

For the best experience, do not use the refresh, stop, back or forward buttons on the browser and only single-click buttons within a page.
An asterisk (*) indicates a required field. You will be alerted if the required information has not been entered.
For your security, all communications are encrypted and you will be logged out automatically if you are inactive for more than 60 minutes.
We recommend the latest version of Microsoft Edge, Mozilla Firefox for Mac or PC, Apple Safari for Mac or PC or Google Chrome for Mac or PC with JavaScript enabled and pop-up blocker turned off to use this site. Please see your browser's help file for more information.

Volunteer Opportunities

Required field Are you interested in volunteering to assist emergency response and public safety organizations (MRC, CERT, GNAS, etc) during a disaster? State Emergency Registry of Volunteers (SERVGA) allows you to affiliate with a variety of organizations that are dedicated to emergency preparedness. Volunteers are utilized during both non-emergencies and emergencies.

Yes No

Required field Are you interested in volunteering for the Georgia Volunteer Healthcare Program (GVHCP)? As a volunteer you will help increase access to healthcare for uninsured and underinsured Georgians. Sovereign Immunity (SI) is provided to licensed health and dental providers. During an emergency or disaster your services maybe requested, however you are not required to volunteer.

Yes No

Account Information

Creating an account is the first step in the SERVGA registration process. You will use your account username and password each time you log into SERVGA.

Username:

The username must be at least six (6) characters long and cannot contain spaces. Acceptable characters include alphanumeric (A-Z, 0-9) and the symbols @, ., -, and _. Usernames are not case sensitive.

Password:

Confirm Password:

Secret Question:

Secret Answer:

Volunteer Agreement

Required field Volunteer Agreement:

By checking this box, I indicate that I agree to the GVHCP Volunteer Agreement and/or the SERVGA Volunteer Agreement and have read and understand the Privacy Policy for this site. My submission of this form will constitute my consent to the collection and use of this information and the transfer of this information across the Internet to processing and storage facilities supporting this system. I also agree to receive required administrative and legal notices such as this electronically.

Required field Information Pledge:

By checking this box, I pledge to provide only correct information when completing this registration process. I also give consent to SERVGA/GVHCP and their designated agents to collect, use, verify, and maintain any information that is collected through the use of this site.

Name and Address

Prefix:

Example: Dr., Col., Mr., Mrs., Ms.

First Name:

Middle Name:

Last Name:

Suffix:

Example: Jr., Sr., MD., PhD, RN

Home Address Line 1:

Home Address Line 2:

City:

State:

County:

Zip Code:

Work State:

Contact Information

Primary Email Address

Delete

Email Address:

If you have an email account, it is important for you to provide this information. Without your email address, you may miss important messages and notifications. Please note that the system will not allow two accounts with the same email address. If you do not have an email address or your email address is already registered with the system, you can learn more about obtaining a free email address by clicking here.

Confirm Email Address:

Add Email Address

Contact Method 1

Delete

Contact Method 1:

Number to Attempt:

x

Pager Type:

Pager Carrier:

Pager ID/PIN:

Add Another Contact Method

Occupation Information

What is your occupation type?

Occupation:

If your occupation does not appear in the list, please select Other.

SERVGA

Registration