Mobile Clinic Volunteer Interest Form
Thank you for your interest in volunteering with the University of Iowa Mobile Clinic.

Please fill out this information form to be added to the following resources:
  •  Mobile Clinic ICON Website (only for volunteers providing an @uiowa email).
  •  Mobile Clinic listserv (for all volunteers)
New volunteers are added each week on Fridays. If you have questions or have not received a response within one week of submission, please email uimobileclinic@gmail.com.
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What is your name? *
What is your @uiowa.edu email address? *
Enter as firstname-lastname@uiowa.edu. If you do not have an @uiowa.edu email address, please type N/A. 
What is your affiliation to the University? *
If you are a student, include your current year of study.
If you do not have an @uiowa.edu email address, enter your personal email address here.
This choice should only be used by volunteers WITHOUT an @uiowa.edu email address.
Do you have any comments that you would like to pass along at this time?
Please also feel free to send inquiries to uimobileclinic@gmail.com.
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