NHC Volunteer Application

Native Healthcare Center is a nonprofit organization dedicated to enhancing the health, wellness, and social well-being of Native American, Indigenous, and underserved communities in Texas. We provide culturally respectful healthcare services, mental health counseling, education, and community-driven initiatives designed to empower individuals and foster equitable access to care. Volunteers play a crucial role in supporting our mission and helping us create meaningful change.

The information provided through this form will be kept confidential and will help us determine the
most satisfying and appropriate volunteer opportunity for you.

Name

PrefixFirst NameLast Name

Volunteer Needs- Contact nativehealthcarecenter@outlook.com for details. Text at 713 309-6417 if needed.

Other

Birth Date

MonthDayYear

Email

example@example.com

Phone Number

Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

College/School

Department/Field

Company

Department/Position

Type a question

Volunteer Dates- (Volunteer coordinator will contact you directly)

Are you able to translate in a different language for patient assistance? If so what language are you fluent in?

In which areas would you like to volunteer?

Which of the volunteering activities interest you?

Do you have any volunteering experience? If yes, please describe.

Volunteer Event Disclaimer and Terms of Agreement

By participating in any volunteer activities or events organized by Native Healthcare Center (NHC), I acknowledge and agree to the following terms: I agree that I am least 18 years of age. I understand that I will NOT be COMPENSATED in any way for voluntaring

Assumption of Risk
I understand and acknowledge that participation in volunteer activities may involve inherent risks, including but not limited to physical injury, illness (including communicable diseases), personal property damage or loss, and unforeseen incidents. I voluntarily assume all such risks associated with my participation.

Release of Liability
I hereby release and hold harmless Native Healthcare Center, its directors, employees, volunteers, affiliates, partners, sponsors, and agents from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, injury, or illness that may be sustained while participating in volunteer activities or while on NHC premises or affiliated event locations.

Medical Treatment

I understand that Native Healthcare Center does not provide medical or accident insurance coverage for volunteers. In the event of an injury or medical emergency, I authorize NHC staff to seek emergency medical treatment as deemed necessary. I agree to be financially responsible for any medical treatment provided.

Personal Property

I acknowledge that I am responsible for my own personal belongings. Native Healthcare Center is not responsible for any lost, stolen, or damaged items.

Code of Conduct
I agree to conduct myself in a respectful, professional, and safe manner at all times. I understand that failure to adhere to organizational policies or event rules may result in my immediate removal from the event or volunteer program.

Media Release (Optional)
I grant permission to Native Healthcare Center to use photographs, videos, or recordings of me taken during the event for promotional or educational purposes. (If not agreed, please notify event staff at check-in.)

Termination of Participation
I understand that my participation as a volunteer is at-will and may be terminated at any time by either party, with or without cause or notice.

Date

Signature

Native Healthcare Center

Educational Background

Occupation

Licensure and Certifications