COVID Vaccinations: Volunteer Interest Form

Thank you for your interest in wanting to volunteer with COVID vaccinations. Beach Cities Health District received generous responses from our community call for medical and non-medical volunteers to assist with COVID-19 community support. Due to the overwhelming response, we are currently reviewing applicants for placement in these roles on an as-needed basis. If you would like to be considered for placement, please fill out our interest list. If you have any questions, please reach out to: BCHD Volunteer Services volunteers@bchd.org Thank you again for your willingness to help our community through this crisis.
 
 

Personal Information

 
 
 
 
 
Please provide us with your medical credentials/License Number. If you do not have medical credentials, please type "Non-Medical."
 
Did anyone refer you to volunteer with us? If so, please state here (e.g., individuals' name, organization name).