Eligibility Requirement for Medical/Dental Professionals

 

1. Have an active license in good standing, issued by a state, commonwealth, territory or the Department of Defense.

2. If retired, have retired in good standing no earlier than One (1) year in the state, commonwealth, territory where the license was issued.

3. If you hold an “Out of State” license, complete the appropriate form below and submit the application to the ARIZONA STATE BOARD.  Once approved you will to receive a 14 day volunteer license number.

NOTE:  Out of State licensure must register a minimum of 21 days before the event in order to complete the process in time.

4. Register with Arizona SonShine on the official website and make sure to add your licence number (or 14 day volunteer license number if applicable) and expiration date.

5. Be approved for malpractice insurance by the event carrier, premium to be paid by Arizona SonShine.

Any questions please contact:

Nancy Adamson, duerksenlawNA@cableone.net | 928-636-4352

or mail to:
Attention: Nancy Adamson
PO Box 1620
Chino Valley, AZ 86323


AZ State Board volunteer registration Forms. Download and Complete the appropriate form below.

 

 

Physician Volunteers:

Click to download PDF
Physician-Volunteer-Registration.pdf

Dentist Volunteers:

Click to download PDF
Dental-Volunteer-Registration.pdf

Nurse Volunteers:

Click to download PDF
Nursing-Volunteer-Registration.pdf