Provider & Pharmacist Application

Dear Provider:

Thank you for your interest in providing services at the Helen M. Nickless Volunteer Clinic. As you may be aware, the Bay County area has a large percentage of indigent (“non-insured”, “under-insured”, “non-employed”, or “under-employed”) persons and families. The Helen M. Nickless Volunteer Clinic is attempting to address the healthcare needs for these persons. All of the health care provision is uncompensated and provided by volunteer health care providers, such as yourself.

You can learn more about the clinic and volunteer opportunities by reviewing the following forms found on this website.

  • Clinic Stats
  • Helen M. Nickless Volunteer Clinic Brochure
  • Professional Application
  • Confidentiality Form
  • Liability Information

You may return your Application and your Confidentiality Form to the Helen M. Nickless Volunteer Clinic. Please note that we will need a copy of your license and CV unless you are on staff at McLaren Bay Region Hospital.

Please contact Joyce Hardy, Clinic Manager at (989) 529-4243 with any questions or for more information.

I look forward to having you join us in this worthwhile community effort.

Sincerely Yours,

Floyd C. Stevens, Jr., D.O.
Medical Director (Volunteer)
Helen M. Nickless Volunteer Clinic