Non-Physician Clinical Volunteer Application

This particular form is specifically for health care workers who provide direct care to patients, are not physicians, and who have licensed medical certifications e.g. RN’s, CRNA’s, APRN’s, LPN’s, etc. Individuals who work in a hospital or health care setting, but who are not licensed medical care providers (i.e. Unlicensed Assistive Personnel) should fill out the ‘General, Non-Clinical Volunteer Form.’