BCMS COVID-19 Volunteer Registration Form


As the COVID-19 crisis increases in our community, physicians and other medical professionals may be asked to volunteer to augment the existing healthcare system in San Antonio and the surrounding area.

If you would be willing to volunteer, should the need arise, please complete the Volunteer Registration Form.

  • As a volunteer, you have the right to say "yes" or "no" to any requests for your services.

  • Physicians do not assume any liability or obligation to volunteer.

  • Your information will be kept secure and shared only with emergency-management officials during a disaster or crisis response.

  • You have the right to decide how far you are willing to travel and how long you are willing to serve.


Thank you for all you do to protect the health and safety of our community!

 

First Name

Last Name

Designation

Specialty

Medical License

Currently in Practice

Military

Retired





(MD, DO, RN, Other)

 (OBGYN, ENT...ect...)





 

E-mail Address
(For Communication Purposes)

Preferred Phone Number
(xxx xxx xxxx)

May We Text You

 

Days of the week you are available

 

 



 
















Sunday


Additional Comments

 

For questions about volunteering,
please contact Melody Newsom at (210) 301-4391.


Click Submit only once. Thank you.