Healthcare Professionals Volunteer Agreement

I have read and understand the Volunteer Orientation and Policy Manual of the Free Access Health Clinic (FAHC), including the Volunteer Rights and Responsibilities, Patient Confidentiality and HIPAA, and Anti-discrimination and Anti-harassment Policy.

I agree to comply with all policies and procedures set forth in the Volunteer Orientation and Policy Manual. I understand that if I do not comply with these policies and procedures, I may be asked to cease my volunteer commitment with the FAHC.

Specialty/Job Title Applying for
Phone (Cell)
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