SMASH DENTAL CLINIC VOLUNTEER FORM

Thank you so much for your interest in volunteering for SMASH at our annual member-only dental clinic! 

Every year, SMASH provides health and wellness services to low-income musicians in King, Snohomish, Thurston, Mason, and Kitsap counties. We are able to do this because of amazing volunteer providers like yourself, that help us serve our local music community. 

Music takes care of us, so we are grateful for your help in taking care of musicians!


We ask our volunteer providers to: 

  • be available for a one-day dental clinic - next clinic is March 17, 2024!

  • be available for a 8-9 hour commitment (including morning orientation, lunch and breaks).

  • communicate in a timely manner with SMASH staff.

  • agree to our volunteer agreement and code of conduct.

  • agree to our confidentiality agreement and liability release. 


If you are interested in volunteering and being put on the clinic volunteer list, please complete this form. Thank you so much, and we will be in touch soon!
Email *
First Name *
Last Name *
Pronouns? *
Required
Phone Number *
Are you a licensed dentist or dental hygienist in the state of Washington? *
Please provide your license credential number for verification. *
Write N/A if a license credential number is not applicable to your selected role.
If applicable, please share with us the dental clinic you work at, or the most recent clinic you worked at. *
How many years of experience do you have as a dentist or dental hygienist? *
Please provide the name and contact information for one (1) professional dental reference. *
We will only contact your reference to verify your credentials in the case that your license number is unable to be verified. Write N/A if not applicable to your role.
Do you need any accommodations for the clinic day that we should be aware of? *
Preferred Volunteer Role? *
Required
Have you volunteered with SMASH in the past? *
What is your T-Shirt Size? 
If you already have a SMASH volunteer shirt you can skip this question. If you need a volunteer shirt please select your size below. If you do not select a size, your size may not be available the day of the show. 
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Anything else you would like to share with us?
PLEASE REVIEW THE VOLUNTEER AGREEMENT. YOU MUST AGREE TO VOLUNTEER WITH SMASH. *
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