Volunteer Interest Form
SMP's empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report healthcare fraud, errors, and abuse. Interested in becoming an SMP? Complete the form below and a volunteer coordinator will contact you.
Full Name
First Name
Last Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about this volunteer opportunity?
Which of the following roles would you be interested in? Consider your experience, strengths and interests, but keep in mind that all volunteers receive training and support to fulfill their roles, so previous experience is not necessary. Please check all that apply.
Administrative Support (This may include scheduling outreach activities, conducting internet searches, data entry, fulfilling requests for information and materials, handling mail etc.)
Exhibitor (This includes transporting supplies to events such resource fairs, distributing written materials, and answering basic questions about the SMP program.)
Information Distributor (This role involves delivering printed materials to senior centers, libraries, and stocking information Kiosks with brochures, booklets, etc.)
Presenter (Presenters make 5-30 minute interactive presentations using SMP approved materials and scripts to medicare beneficiaries, their caregivers and other members of the public.)
Counselor (Counselors discuss individual situations with Medicare beneficiaries and/or their caregivers. They may review Medicare Summary Notices and other related medical/financial documents, provide education about Medicare fraud, errors, and abuse, and make referrals when a client needs more complex assistance.
I'm not sure which role is right for me.
Tell us why you are interested in volunteering with Senior Medicare Patrol.
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