Human Services Professional Application

We are looking for licensed/ certified human services professionals to volunteer in our clinics. We are unable, in most cases, to facilitate observation hours in our clinics. If you have a prior special arrangement with one of our social workers please have them contact our social work manager to make arrangements.

Are you currently certified/ licensed? *
Please tell us which USA certified license, certification, degrees you have:
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?
Name *
Date of Birth *
Date of Birth
Phone *
Street Address, City, State, Zip
Would you like to be added to our mailing list? *
Billy Kangas