Vaccine Program Registration - Clinical & Epic Registration Volunteers

ATTENTION: IF YOU ARE AN EMPLOYEE FROM A STAFFING AGENCY, DO NOT COMPLETE THIS FORM. YOU ALREADY HAVE AN ACCOUNT. LOGIN HERE WITH THE EMAIL ADDRESS YOU PROVIDED TO THE AGENCY.
ATTENTION: IF YOU ALREADY COMPLETED THIS FORM, AND ARE TRYING TO SIGN UP FOR MORE SHIFTS, LOGIN TO THE EMPLOYEE & VOLUNTEER PORTAL HERE. DO NOT COMPLETE THIS FORM MORE THAN ONCE UNLESS YOU ARE EXPLICTLY TOLD TO.

Thank you for your interest in volunteering for the Houston Methodist COVID-19 vaccine event. Please complete the information below to register for a volunteer account. Once you submit this form, your information will be verified within 48 hours. Once the verification process is complete, you will receive an email inviting you to sign up for volunteer shifts.

Personal Information - CLINICAL AND EPIC REGISTRATION - Make an Account

DO NOT COMPLETE THIS FORM MORE THAN ONCE UNLESS YOU ARE EXPLICITLY TOLD TO.

* First Name

* Last Name

Gender

* Date of Birth

* Houston Methodist Email Address (only HM employees are eligible to sign up).

* Cell Phone Number

* Title

Please select your business unit. If you do not see your business unit listed, select 'Other' and type it in the box below. IMPORTANT NOTE: only RNs and individuals in BU 23000 and 24000 are considered 'clinical' volunteers for the purposes of the vaccination events. If you do not meet this criteria, please sign up for volunteer shifts using this form instead.

* Specify Business Unit

Please select your stafifng agency.

* Manager First Name

* Manager Last Name

Please select your credentials. If you have more than one credential on this list, select the highest level credential.

Which of the following duties are you trained to perform (select all that apply). If you are not trained to perform these duties, you do not meet the criteria for a 'cinical volunteer' at the vaccination event. Please sign up for volunteer shifts using this form instead.

Which HM hospital have you been told to sign up for? If you were not instructed to sign up, please select the location you will primarily be assisting at.

Are you non-exempt (paid hourly), exempt (paid by salary) OR a contract worker from a staffing agency (paid hourly)?

Do you speak Spanish?

Please click submit to complete your profile registration. Once your information is verified, you will receive an email inviting you to sign up for volunteer shifts.

Houston Methodist Hospital Vaccine Program Registration - Clinical & Epic Registration Volunteers

Welcome! Make an Account to Begin

Personal Information - CLINICAL AND EPIC REGISTRATION - Make an Account