Volunteer Application
Thank you for your interest in volunteering at Impact Mental Health. We highly value our volunteers and the services they provide to help our clinic run smoothly.

There are two volunteer positions we wish to fill at the clinic- Spanish Interpreters and Care Coordinators.

Fill out this application and submit it to our volunteer coordinator. Upon review, she/he will reach out to schedule an interview if it is determined that volunteering at this clinic would be a good fit. We require our volunteers to serve at least one full shift per week (3-4) and provide training in all areas that volunteers assist. Training consists of online athena training that is done outside the clinic and on-site training upon first day in clinic. Once this has been completed, you will be fully equipped to volunteer and have a major impact!
Name
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Email
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Address
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Date of Birth
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Primary Phone Number
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How did you hear about us?
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What do you expect to gain from your volunteer experience?
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List any previous volunteer experiences:
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List any skills you have that may be used in the clinic:
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How many hours per week/month would you like to volunteer?
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What days/times are you available to volunteer?
Have you ever been convicted of a felony?
Emergency Contacts (Please provide name and number)
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Education (include all that you have completed beginning with high school)
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License/Certification
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3 References (Include Name, Phone Number, and Email Address)
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