KNIGHTS CLINIC PHYSICAN VOLUNTEER: Preview on Page 1

KNIGHTS CLINIC PHYSICAN VOLUNTEER: 2026

The document provides detailed instructions for physicians interested in volunteering at the KNIGHTS Clinic at Grace Medical Home in Orlando. It outlines the necessary paperwork, including confidentiality agreements and consent forms, that must be completed four weeks prior to volunteering. The clinic operates twice a month and seeks volunteers from various medical specialties to provide care for uninsured patients. It emphasizes the teaching opportunities available for medical students and assures volunteer physicians of legal protection against liability through a Sovereign Immunity Contract.

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Click ‘Get Form’ to open the KNIGHTS CLINIC PHYSICAN VOLUNTEER form in the editor.
Begin by filling out your personal information in the 'Primary Care Physician Volunteer Application' section, including your name, work address, and contact details.
Complete the medical license number field and attach a copy of your license. Ensure that your license is active as indicated in the form.
Proceed to fill out the 'Confidentiality Statement' and 'Media Release Form'. Make sure to read each statement carefully before signing.
For the 'Physician Sovereign Immunity Contract', indicate if you are affiliated with a Professional Association and provide necessary details if applicable.
Once all sections are completed, review your entries for accuracy. Save your document within our platform for easy access.
Finally, send all completed forms to Stephanie Garris via fax or email as specified in the instructions.

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