Please complete this application form if you are interested in becoming a University of Pittsburgh volunteer in a CLINICAL role. You must have a current and active affiliation with the University.
The fields which are followed by an asterisk are required for everyone. Please complete ALL fields that are applicable to you and you may skip the ones that are not. You will only click "check" in the fields with a checkmark box if your answer to the question is "yes".
Once you complete the form, click the Continue button at the bottom.
• Once you successfully submit the application form, an acknowledgment message will appear on the screen
• You will also receive a submission confirmation email with additional information on next steps.

Profile Information

Education and Professional Information

Emergency Contact Information


I understand and agree that submitting this application form does not automatically register me as a University of Pittsburgh 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.
If applicable, I attest that I am currently licensed and in good standing with the Pennsylvania state board for my health profession.
By submitting this form, I attest that the information I have provided on the form is true and accurate.