Contact Us



Centro Cristiano de Servicios Humanitarios de Honduras
El Progreso, Yoro  Honduras  C.A
Telephone (504) 647-0990 / 9791- 9031 / 608 5791 /  5792

Application Form:

If you are a doctor interested in helping us for one or two weeks, please fill out the following form.

Please register me for: Weeks.
Specialty:
Number of surgeries per day:
Preferred date to visit: from to See available dates:
Secondary option: from to
Please attach the following items:
Copy of your passport. If you don't currently have a passport, please contact our office when it comes.
Please include a scanned copy of your liscense and diploma
  if you are are a specialist in ophthalmology, medicine, optics, or dentistry.
Doctors, send a resumé and, if possible, a list of the procedures you can perform
Name as written on the passport   Male / Female
Insurance number:
Passport Number: (Leave blank if you don't have a passport yet; and contact us when you get one)
Title:
Nationality:
Special interest in the area of:
Other areas of interest:
Prior experience: Years.
Student:

Year of graduation

As: Ophthalmologist / Dentist / Optometrist

State of health

I am taking important medications  

I have Allergies, Diabetes, or High Blood Pressure Please specify:

CCSHH

How did you hear about CCSHH?: Website

Publication/Article / Conference /  Friend /  Other

Previous Medical, ophtalmologic, or Dental projects already participated in:
Languages besides English:
Special Talents or abilities
  Thank you for choosing CCSHH. We will provide you with additional information about our country and region.

If you want to help finance our projects, medications, surgical instruments, ophtalmologic equipment, etc, please contact Melvin Tejada, our executive director. Address: CCSHH; El Progreso, Yoro; Residencial Pires 1 calle; Honduras C.A. Telephone: (504) 647 0990 or (504) 9791 9031; e-mail: ccsm@globalnet.hn


If you live in the United States and want to make a tax-deductible donation, please contact Maxine Perry at dperry3603@aol.com *Participation does not include the cost of the airlines.

Important:

If you have additional tourism plans, please specify to us which places that you would like to visit. You can make your arrangements directly by visiting http://www.letsgohonduras.com/

© CCSHH, All rights reserved
Created by Christian R. (800x600)

Ophtalmology   I  Dental  I  Optometry  I  Special Projects  I  Visiting Medical Program
Medical Equipment  I  Project Calendar  I  Spiritual Area  I  Contact Us   I  Donations I  Newsletter  I  Home

.