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San Bernardino County Sheriff Medical Reserve Corps

Online Volunteer Sign-Up Form

The San Bernardino County Sheriff Medical Reserve Corps is looking for a variety of individuals who are willing to volunteer their skills and knowledge to serve their communities when public health emergencies hit close to home. Whether you have medical skills, mental health skills, or simply want to contribute to public health and safety, there is a place for you in the MRC. We are looking for:

  • Licensed medical professionals (such as nurses, physicians, pharmacists, dentists, physician assistants, EMT's, medical technician's, veterinarians).
  • Non-licensed volunteers with medical background (such as medical records, medical receptionist, health educators).
  • Mental health professionals (such as counselors, therapists, psychologists, psychiatrists, social workers, clergy).
  • Volunteers with other specialties (such as computer specialists, translators/interpreters, public information specialists).
  • Non-medical community members to provide basic support.


To apply to become a Medical Reserve Corps Volunteer,

EITHER

1. DOWNLOAD the form below and MAIL it completed to the following address:

Download the form in *.pdf format:

Mail this form to:
San Bernardino County Sheriff Medical Reserve Corps
P.O. Box 11029
San Bernardino, CA 92423-1029

OR

2. COMPLETE the form below:

Volunteer Information
* First Name:
*Last Name :
Mailing Address:
Address 2 (Suite #):
City:
Zip Code:
Phone Number:
*E-mail Address:
I prefer to be contacted by:
postal mail email.
*Professional Designation :
*Professional License Number:
*License Expiration Date:
Month/Day/Year
Languages Spoken :
Other Special Skills
Comments:
Press the "Submit Form " button to send your registration.


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