Free Clinic Volunteer Application- Spring 2018
IMED is partnered up with Lestonnac free clinic to provide volunteering opportunities for IMED members. As a volunteer you will be able to gain medical exposure though free clinic administrative work (such as checking in patients and scheduling appointments) along with gaining Medical Assistant experience (recording vitals, writing prescriptions for patients) and you will be able to shadow your choice of health care professionals.

As a volunteer, you are required to
1. Undergo training for front office, back office and shadowing
2. Dedicate at the most 6 hours biweekly to free clinic
3. Be a paid IMED member
4. Commit for the entire quarter to participate in your designated shift biweekly. You are able to miss 1 free clinic with a valid excuse of absence. You must notify the Outreach Coordinator of your absence 1-2 weeks prior to your absence.
5. Wear Scrubs to the Free Clinic
6. Participate in an information training session prior to your start date.

Location: Los Alamitos Walk-In Medical Clinic, 5122 Katella Ave #308, Los Alamitos, CA 90720
When: Starting April 1st
Deadline to Apply: March 23rd 8PM

Name
Your answer
Year
Major
Your answer
Email
Your answer
Are you a paid IMED member?
Have you participated in free clinic with IMED before?
The following are the shift times for free clinic. Please mark all the shifts that you are available to volunteer for. Please note that Saturdays may be impacted and the spots will be limited to 8 volunteers for each day. The more days you are available to volunteer for the more likely you will be able to volunteer at the free clinic. (Shifts are subject to change depending on how busy the clinic is on a certain day, but you will not be required to stay past 2 PM.)
Please fill out the following grid according to your class schedule. If you have class on Monday or Friday during any of these times please mark the box accordingly.
8-8:50
9-9:50
10-10:50
11-11:50
12-12:50
1-1:50
2-2:50
3-3:50
Monday
Friday
Do you speak Spanish? (This will not be a deciding factor)
Can you drive yourself and others to the free clinic (This will not be a deciding factor. All drivers are reimbursed)
Should you be chosen to volunteer for free clinic, please fill out this When to Meet poll to solidify the date of free clinic orientation! Please note that this is a MANDATORY meeting for all accepted volunteers and should only last 1 hour, but please fill out ALL your availabilities and not just preferences. Once you have filled out this poll, please type "done" in the space below. https://www.when2meet.com/?6736945-IeI3g
Your answer
In 200 words or more, please describe why you would like to volunteer for free clinic. This will be the deciding factor for volunteering positions.
Your answer
Notes
Your answer
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