Worcester Free Clinic Interest Form
Please fill out this form to indicate your interest in becoming a volunteer, back-up volunteer, or newsletter subscriber with the Worcester Free Clinic Coalition. For volunteers, we are specifically looking for physicians, nurses, phlebotomists, case managers, social workers, medical translators, and lawyers. But, if you are interested in volunteering or helping the Worcester Free Clinics and do not have any of the above roles, let us know anyways and we will find a way for you to contribute. Once you sign up, a member of the Worcester Free Clinic Coalition will contact you with further details.
Email address *
What is your name?
Your answer
What is your email address?
Your answer
Specialty / Field
Your answer
Resident Physician?
Are you interested in volunteering with the the Worcester Free Clinics? Clinics are held on weekday evenings. You can volunteer as much or as little as you would like.
What is your typical availability in the week?(Monday at Epworth - Tuesday at St. Anne's - Wednesday at ISW or Greenwood - Thursday at Akwaaba)
How frequently would you like to volunteer?
Are you interested in being a back-up/reserve volunteer? Back-up volunteers will not be asked to commit to any dates, but provide times they can be contacted when a free clinic is in danger of closing due to lack of trained medical staff. Closures of this type occur infrequently, but have significant impacts on our patients when they do.
Are there any other ways in which you could support the Worcester Free Clinics? In addition to medical volunteers, we are also looking for case managers, social workers, medical translators, legal help, connections within the community, and any other type of support.
Your answer
Would you like to hear about upcoming events, fundraisers and community initiatives led by the Worcester Free Clinic Coalition?
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