WellMed Vaccine Clinic External Volunteer App

WellMed Vaccine Clinic External Volunteer App

Thank you for your interest in volunteering at the WellMed Vaccination clinics. We are thankful for our volunteers who help us vaccinate our community. We need happy, smiling faces who are willing to serve in both clinical and non clinical roles: Clinical volunteers can vaccinate patients with an LVN, MA, RN or MD credential with current license. Non clinical volunteers are needed to help with patient monitoring, front door screening (PPE provided), check in and running traffic onsite. You will be in doors and standing for the duration of your shift. We are located at: Alicia Trevino Lopez Senior Center 8353 Culebra Rd, SATX 78251 Elvira Cisneros Senior Center 517 SW Military Dr, SATX 78221 Doris Griffin Senior Center 6157 NW Loop 410, SATX 78238 Please submit your information below and a member of our scheduling team will be in touch as soon as we can. We typically send the schedule out with updates once a week. Please note: your submittal of this form does not guarantee you a volunteer position. They are based on availability and need.

First Name*

Last Name*

Email address*

Phone Number*

Address*

City*

State*

Zip*

I have been referred by a WellMed employee

Full name of WellMed Employee who referred you:

I have been referred by another volunteer

Full name of volunteer who referred you

I work for a United Health Group Company

Which UHG Company do you work for?

Select or enter value

I am bilingual (Spanish speaker)

I have clinic/healthcare experience

Please list active credentials (MD,RN,LVN, MA,etc)

I have experience with Microsoft Excel/SmartSheet

Volunteer Shift Commitment

We ask volunteers to commit to 20 hours of service to be eligible for the vaccine. The hours can be completed in any combination of half-day and/or full day shifts over a span of 2-4 weeks. Unfortunately, we cannot accommodate one-time volunteers.

I understand volunteer shift commitment*

Vaccine Acknowledgement

If you are interested in the vaccine, we will make every effort to offer it each time you work, however we cannot guarantee it. If you do not receive your vaccine after 20 hours of service, we will schedule you an appointment to receive the vaccine at a later date. Please understand that our goal is to consistently staff the clinics. We are very grateful for your time, but the vaccine is not intended to be a payment for your service. Instead, it is meant to protect you as a frontline worker in the clinic. Our hope is that you will continue to help once you are vaccinated.

Have you received your COVID vaccine?

Select or enter value

I understand the Vaccine Acknowledgement*

Code of Conduct

We are privileged and grateful to offer the vaccine to our community and see every patient as an opportunity to make a good impression. Our commitment to you is to provide a meaningful and positive volunteer experience. Likewise, we expect our volunteers to arrive ready to work with a helpful and positive attitude. Overall it is important to be kind. You may be asked to perform different roles while in the clinic and we ask for your understanding and flexibility. We do reserve the right to dismiss any volunteer who is not behaving in a manner that is unacceptable in the clinic. If we all try our best and work together we will get our community vaccinated!

I agree to the code of conduct

Send me a copy of my responses

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