Volunteer With Better Vision Better Hope
Use the form below to sign up for clinics that are coordinated directly with Better Vision Better Hope. Our team will follow up with details and next steps.
Select a BVBH Clinic
Please Select
January 24–25 — Garland, TX
February 24 — Huntsville, AL
March 12–13 — Phoenix, AZ
April 11–12 — Beltsville, MD
April 26 — Sandy, OR
May 17 — Mt. Pleasant, TX
June 7 — Katy, TX
October 31 – November 1 — Madison, TN
Volunteer Interest
Please Select
General Volunteer
Ophthalmologist (M.D.)
Optometrist (O.D.)
Optician
Optometric Tech/Assistant
Full Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
example@example.com
Date of Birth
-
Month
-
Day
Year
Date
Mobile Phone Number
Format: (000) 000-0000.
Emergency Contact Name
Emergency Contact Phone Number
Format: (000) 000-0000.
Professional License Number and State of Issue
Upload License
Upload a File
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Volunteer Waiver and Media Release By submitting this form, I acknowledge and accept the following:
I understand that volunteer work may involve physical activity, lifting, and working in medical environments.
I release Better Vision Better Hope and its partners from any liability for injury or illness that may occur during my volunteer service.
I understand and agree that all expenses related to my participation as a volunteer — including but not limited to travel, lodging, meals, transportation, and personal supplies — are my sole responsibility
I grant permission for photographs and video recordings taken during clinics to be used for educational, marketing, and promotional purposes by Better Vision Better Hope.
HIPAA Notice:Better Vision Better Hope is committed to protecting patient privacy. As a volunteer, you may be exposed to protected health information (PHI). By submitting this form, you acknowledge your responsibility to maintain confidentiality and comply with HIPAA privacy requirements at all times.
I understand that checking this box constitutes a legal signature confirming that I have read, understand, and agree to the terms above.
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