Register as a Volunteer

Step 1:

The first step in registering as a MOM Volunteer is to create your profile below.

  1. Choose a Username and Password that you can use in the future to make changes or updates to your volunteer profile.
  2. When selecting a Volunteer Position, please DO NOT register for a position that you are not qualified and/or licensed for. If you are a STUDENT or other MEDICAL PROFESSIONAL (non-dental) please register as a General Volunteer and specify your volunteer status when completing your full profile in the next step.
  3. When you complete this form you must check the box at the end which indicates you have READ and AGREE TO the Liability and Insurance Guidelines and Waiver. Please do not submit your registration if you do not agree to the waiver.
  4. You will move on to the second step and provide your volunteer information (see below).
Your display name will appear here.
Password must be at least 7 characters long. To make it stronger, use upper and lower case letters, numbers and symbols.
Type your password again.
Strength Indicator
Personal Information 
Only volunteers 18 years or older will be allowed on the clinic floor. Non-patient related positions will be available for those under 18.
I certify that I have READ and AGREE TO the Liability and Insurance Guidelines and Waiver (here).

Step 2:

After registering, you will be able to edit your profile and provide additional information regarding your qualifications, volunteer position, dates and times available, etc.  Simply click the Edit Profile button on the next screen to provide additional contact information, specify skills, and choose your times available.