Please complete this application form if you are interested in being a Volunteer Medical Provider (MD, DO, NP, PA, RN) or Pharmacist at CommunityHealth. Once you complete the form, click the Submit button at the bottom of the application.
CommunityHealth operates in compliance with the Illinois Good Samaritan Act. Per the state statute, with the exception of willful or wanton misconduct, all volunteer licensed medical professionals are exempt from medical liability.
All volunteers are screened through the Office of the Inspector General Exclusions Program and the Excluded Parties System List. Any volunteers for which professional licensure is required will be screened through the Illinois Department of Professional Regulations.
***If you are not a licensed/certified provider, please sign up for a clinic volunteer info session on the volunteer page of our website. Do NOT fill out this form.***