Volunteer Inquiry - MAVEN Project

We welcome physician inquiries from primary care doctors and specialists to volunteer by providing medical consults, medical education, and/or mentoring to primary care providers in community health centers via our telehealth platform. Please note, volunteer demand varies by specialty, and we may not have a position available for you at this time.

Please also note, you will need to upload your CV to complete the volunteer form below.

Sal.*

First Name*

Last Name*

Email*

Mobile Phone Number*

What best describes the area of medicine in which you are trained? If you are trained in multiple specialties, please click “Add another area of medicine” on the righthand side of the page. If your specialty is not listed, please select “Other” in the dropdown menu.

Area of medicine in which you are trained?*

Please describe the other area(s) of medicine in which you are trained:

Please mark all states in which you hold an active medical license, including volunteer medical licenses:*

Upload CV*

Max. file size: 100 MB.

Please include a copy of your most current CV to help us learn a little more about you.

How would you describe your current work status?*

Please enter the month & year of your retirement.

Other. Please share any comments or questions.

Are you currently board certified?*

Yes

What is the date of your most recent board certification?*

Is there anything else you'd like us to know about your board certification?

Briefly describe your clinical practice.*

When were you last active in clinical practice?*

Have you worked for or retired from Kaiser Permanente?*

Yes

Would you be interested in being a speaker for our medical education webinars?

Yes

Race & Ethnicity*

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native American or Hawaiian or Other Pacific Islander

White

Two or more races

I do not wish to provide this information

What is your gender?*

How did you initially hear about us?*

If "Other", please tell us more:

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Volunteer Inquiry Form

Ready to join MAVEN Project?

How MAVEN Project can partner with me and my clinic.

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How I can become a volunteer physician.

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How I can support MAVEN Project’s mission.

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