This application must be submitted in order to be considered as a volunteer with Medical Relief International. Please fill out the following form for MRI records.

Thank you for your time. 

Basic Information

Employment Information
Education & Experience
Emergency Contact Info
Insurance Information

Please print off the Medical liability release form. Word DocPDF

Please fill out, sign and scan, and send to


I have reviewed this application, and everything is accurate, and I am responsible for any inaccuracies, and agree to pay any fees related to any mistakes on my part.

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