EMC - Volunteer Form

Thank you for considering to apply to volunteer for EPIC Medical Clinic. Please review the requirements listed below.

*Please note that applying for a volunteering position does not guarantee the opportunity. Following the completion of this application, you will be contacted via email if we have any openings and if you qualify to move forward to the next step of having an interview with the Clinic Leads.*

Requirements for ALL Volunteers:

1) Once the volunteer on-boarding process is complete which includes the interview with the MA Lead Team and the volunteer is selected to join the team, then they are required to do the HIPAA Certification.

P.S. You do not have to do the HIPAA Cert until on-boarded.

Please use this specific link:

https://nalearning.org/hipaa/volunteer%40epicmedicalclinic.org

Referral code: volunteer@epicmedicalclinic.org

2) Minimum age required to volunteer is 18 years.

3) We require scrubs for all staff (except MDs). You can purchase a set from wherever you would like. The color can be black or blue.

4) You are required to take at least 12 shifts in the course of 12 months. One each month, so you are more frequent and aware of all the changes and updates in terms of our procedures and clinic operations.

5) Non-physician volunteers are required to participate in clinic operations for at least 6 months before a letter of recommendation can be issued if needed.

A minimum of 1year committment is required.

JazakAllah Kharin.

If you meet the above requirements, you may proceed to fill out this application.

Name*

First NameLast Name

Volunteer As*

E-mail*

Date of Birth*

Date

Gender

How long do you plan on staying?

3month, 6months, 1 year, 2 years?

Contact Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Preferred Day*

How many hours are you available to volunteer per month?

How long do you think you will stay and volunteer with EPIC Medical Clinic?*

Describe your medical experience (if any).*

Have you worked with any EHR (Electronic Health Record) System?*

What motivates you to commit to volunteering with EMC?*

Describe a time when you made a mistake and how you corrected it.*

Describe a time where you exceeded expectations.*

Describe a time when you handled a stressful situation*

Anything you would like to share about yourself that would be beneficial for this position.*

Please attach your resume.*

Browse Files

EPIC Medical Clinic Volunteer Application