Get Davis County Medical Reserve Corps Application (pdf) - Daviscountyutah

Filling out the Davis County Medical Reserve Corps Application is a crucial step for individuals interested in volunteering their skills for community health efforts. This guide provides clear and detailed instructions to ensure a smooth application process.

Follow the steps to complete the application efficiently.

1. Click ‘Get Form’ button to access the form and open it in your preferred document editor.
2. Begin by entering your personal information clearly. Fill in your last name, first name, middle initial, and full address, including city, state, and zip code.
3. Provide your contact details. This includes your home phone, work phone, mobile phone, and any other phone number you wish to include.
4. Indicate your current job title and employer; provide your employer's address, phone number, and the name of your employment supervisor.
5. List your professional references. Include their names and telephone numbers, as well as your current certifications and licenses. Ensure to specify the type of certification, its number, the state issued, and the expiration date.
6. Note any special needs you may have, such as wheelchair accessibility. This ensures appropriate accommodations are made for your involvement.
7. Check the type of support or service you may be assigned to from the listed options, such as physician, nurse practitioner, or mental health worker.
8. Indicate whether you have transportation by selecting 'Yes' or 'No.'
9. Read the list of responsibilities noted in the agreement section. By signing, you acknowledge that you understand your commitments, including agreeing to a background check and attending training.
10. Sign and date the application. Additionally, indicate whether you would like your name included in the Utah State MRC Database by selecting 'Yes' or 'No.'
11. Review your completed application for any errors or omissions. Once reviewed, save your changes and proceed to download, print, or share the form as needed.

Complete your application online today and take the first step towards serving your community!