Clone of Community Health Experience Screening Volunteer Sign Up

Volunteer Sign-Up Form (Los Angeles, CA)

We’re thrilled to have your support at one or multiple CKD screenings in Los Angeles, CA between 10/13/2026 to 10/15/2026. Thanks to your help, we’ll provide rapid CKD assessments to participants, identifying signs of kidney issues and related risk factors. In addition to on-site health testing, participants will receive personalized education, prevention materials, and resources to support their health journey. Please note that volunteers must be 18 years of age or older. Thank you for being part of our volunteer team!
Full Name

First NameLast Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please indicate whether you are affiliated with any of the following organizations:

Other
Job Title
List any medical certifications you hold. If none, please put n/a.
Are you able to provide bi- or multi-lingual translation support on site?
If yes, what language? (Spanish, Korean, Mandarin, etc.)
Screenings will be held on the following dates/times:
- Tues., October 13: Watts Labor Community Action Center
- Wed., October 14: Pico Union Project
- Thur., October 15: L.A. Care Lincoln Heights
Please indicate all the dates you're available to volunteer below.
Please indicate which date(s) you are available to volunteer.
What is your T-shirt size? Please note due to limited inventory, we may not be able to accommodate all sizes.
Any special message you need us to know?
*Please Note: Our team will review all applications and contact you to confirm your schedule based on availability and event needs. We will schedule a virtual training to provide an overview of the process.

Invites will be sent as we get closer to the dates!
Should be Empty:

*Please Note: Our team will review all applications and contact you to confirm your schedule based on availability and event needs. We will schedule a virtual training to provide an overview of the process.