Email Address

Which Clinic(s) would you like to volunteer at?

We have two clinics. Our Wayne clinic is open Tuesdays from 9-2 (and 5:30-8 on 3rd Tuesdays), Fridays from 9-2, and Saturdays twice a month from 8:30-12. Our Ypsilanti Clinic is open Tuesdays 8:30-5, Wednesdays 8:30-noon & 5-7:30pm, Thursdays 8:30-5, and Saturdays from 8:30-12. I am interested in volunteering at:

Wayne

Ypsilanti

I am interested in offering pro-bono services at my own facility for referrals.

A year long commitment.

We are looking for medical professionals who are willing to make a one-year commitment. Are you able to commit to volunteering for at least one year?

Yes

Name

First Name

Last Name

Date of Birth

YYYY

Address

Street Address, City, St, Zip

Phone

(###)

###

####

Please tell us about your Relevant Work Experience.

Please tell us about your Education and Skills.

Church

We don't require you to be a member of a church to work with us, but if you are involved in a church we would love to know about it.

Please tell us how you heard about volunteering at Hope.

Thank you for your application to volunteer with Hope Clinic. We will review your application, and we will contact your in about two weeks to discuss volunteer opportunities and placement.

Licensed Medical Professional Interest Form

a haven of
help + healing.

Ypsilanti clinic

wayne clinic

Helpful Links

Licensed Medical Professional Interest Form

a haven of help + healing.

Ypsilanti clinic

wayne clinic

Helpful Links

a haven of
help + healing.