Contact Information

State / Province*
Confirm Email*

Volunteer Information

Current Volunteer Positions Available*
  • ADMINISTRATIVE - Mailing letters, helping with phone calls, making copies, packets, and scanning
  • BILLING - Review and mail monthly patient statements, file remittance advice, scanning, contacting patients regarding refunds and inquiries, audit Health Plan websites monthly to ensure provider information is accurate and up to date, and other duties
  • CHAPLAIN - Available to pray with patients and staff either in person or on the phone
  • DENTAL ASSISTANT - Assist doctors, oral surgeons, and other assistants with day to day tasks
  • FRONT DESK - Help sign in patients, handle phone calls, make copies, and scan files into patient files
  • HOMELESS OUTREACH TEAM (HOP) - (Females only currently) Doctors, NPs, and PAs to assist the HOP in providing medical care to people on the street
Why are you interested in volunteering with Covenant?
What days and times are you available?
What skills and/or previous experiences do you have that connect with the volunteer opportunity?
Have you had a tuberculosis test in the past year?*
  • Yes
  • No
If you have not had a TB in the past year, would you be willing to get one for the position?
  • Yes
  • No
  • Contact me about this topic
Would you submit to a background check?
  • Yes
  • No
  • Please Contact Me About This Topic
May we send you updates about Covenant?
  • Mail & Email
  • Only Mail
  • Only Email
  • I Don't Want to Receive Updates

Emergency Contact

Please enter the name, address and contact information of someone Covenant can contact in the case of emergency. 

Name, Address & Contact Information
I understand and agree that submitting this application form does not automatically register me as a Covenant volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.
  • I Agree
Additional Comments
Powered by eTapestry.