Professional Medical Providers Volunteering

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Medical Providers Volunteer Requirements

Eligibility

Thank you for your interest in volunteering at the Leahy Community Health and Family Center (LCHFC). Please click here for a letter from the Director of the LCHFC to all physicians, nurses, and other medical providers looking to volunteer.

To be eligible to volunteer at the LCHFC all professional medical providers and nurses must submit proper forms and clearances.

Medical Provider Volunteers

Professional Medical Volunteer Providers must obtain and submit the following forms:

Review the CFPB Summary of Rights document. Sign the Acknowledgement and Authorization for Background Checks. Provide to the Leahy Community Health and Family Center. You must understand your rights prior to submitting for Federal and State Clearances.
Volunteer Provider Initial Application
Statement of Fitness/Medical Clearance PPD
or
Instructions for how to complete this clearance can be found on page three of the PDF.
Instructions & service code to complete the
Volunteer License Application --

Nursing/Pharmacy/Other Healthcare Providers

Volunteer Nursing/Pharmacy/Other Initial Application
Statement of Fitness/Medical Clearance PPD
or
Instructions for how to complete this clearance can be found on page three of the PDF.
Instructions & service code to complete the
Volunteer License Application --

Physical Therapy Volunteer Providers

Physical therapy providers interested in volunteering must obtain and submit:

or
Instructions for how to complete this clearance can be found on page three of the PDF.
Physical Therapy Provider Initial Application
- Statement of Fitness/Medical Clearance PPD

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Medical Providers Volunteer Requirements

Eligibility

Medical Provider Volunteers

Nursing/Pharmacy/Other Healthcare Providers

Physical Therapy Volunteer Providers

Leahy Center

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