Volunteers

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 June 17, 2016 in the state, commonwealth, territory where the license was issued.

3. Register with Arizona SonShine 2018 on the official website.

4. If licensed other than in Arizona, be approved by the relevant Arizona board for a 14 day volunteer license.

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

If you hold an “Out of State” license, complete appropriate form (click on form link below) and forward to license processing, DO NOT FILE with State of Arizona, as this may delay or deny your request. Arizona Sonshine must file directly with the state.

Out of State licensure must register by March 31, 2018 in order to complete the process in time.

Licensure/Insurance processing will be in direct contact with you to complete the registration process, but the ARIZONA STATE BOARD forms must be completed and sent directly to:

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

or mail to:
Russell Duerksen,
Attention Sherry Budd
PO Box 1620
Chino Valley, AZ 86323


Additional 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