Physician Interest Form
Thank you so much for your interest to be a volunteer physician for the Dade County Street Response! Physicians play an integral role in making our clinics a success. The street rounds are every Saturday from 8am-11a. The urgent care is operating every Thurs-Sunday 9-3pm. All supplies & PPE will be provided.
For more detailed information about our services, policies, and operations, feel free to explore our website or Operations Manual:
Feel free to contact Armen Henderson at
and Dan Bergholz
with any questions. We respect your time and sincerely thank you for offering your expertise for this important community outreach effort.
Sign in to Google
to save your progress.
If you have already spoken with us and completed the volunteer training - or you just want to see the dates and times - please feel free to use the self-signup below. Otherwise, submitting this google form gets your information down on our list and you will be contacted as opportunities arise.
Doctors Within Borders:
Miami Street Medicine:
---> Please sign up under the role, "Provider" or "Clinical Support."
If an attending physician, please provide your license number if you would like us to organize a Fl. Dept. of Health sovereign immunity contract for you.
The Volunteer Health Care Provider Program (VHCPP) provides an avenue for health care professionals to provide donated medical/dental care to the uninsured and low-income residents of Florida while under the protection of sovereign immunity. Meaning, the State of Florida is solely liable for any injury or damage suffered by a client receiving health care, as long as the provider works within the scope of his/her job description and is an agent of the state.
Do you currently hold (or have you ever held) an active VHCPP contract through the Florida Dept. of Health
Yes (currently active)
Yes (currently inactive)
Which Programs Would You Like To Volunteer With?
Miami street medicine, doctors within borders
Miami Street Medicine (Sat 8-11am)
Doctors Within Borders Free Urgent Care (Th-Sa 9-3p)
Advocacy and Community Organizing
If you have specific availabilities or conflicts, feel free to let us know here.
Send me a copy of my responses.
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