Registration: Kind Clinic

If you have already registered for access to our online scheduling system and you have already received your welcome email message with your temporary password, please sign in using that password. 

If you have not completed this form, thank you for taking a moment to complete and submit the following details.

Thank you for your patience, it might take a few hours or days until your registration has been processed.


* required field
APPLICANT INFORMATION
 

General Information
Emergency Contact Name
Emergency Contact Phone Number
Emergency Contact Relationship
What is your date of birth?
How did you hear about volunteer opportunities at the Kind Clinic?
If a staff member or volunteer referred you, who was it?
Most people want to volunteer to give back to their community. What are your reasons for wanting to volunteer at the Kind Clinic?
By checking this box you certify that all responses to this form are true to the best of your knowledge. You also agree that all information may be verified by the Texas Health Action.
 Yes

We store cookies and other data on your device to help us deliver our services. By using Shiftboard, you agree to our use of cookies and confirm that you have read and accept our privacy policy.  



We appreciate your time and interest


 
 

×
Loading...
Loading...
Loading...
Getting help...

Error

×