BCMS Emergency Preparedness Volunteer Registration

  • 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 response.

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

 

First Name


Last Name



Designation



Specialty



Medical License



  



(MD, DO, RN, Other)



 (OBGYN, ENT...ect...)



Email 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.