Volunteer Form – Dental Assistant

Volunteering offers you the opportunity to make a real difference in the lives of some of Australia’s most underprivileged people. Filling the Gap runs charity clinics in the four chair facility of the Clinical Training Centre at ADA NSW in St Leonards. These clinics are run in partnership with charities that support patients who have difficulty accessing dental care. We see a variety of patients including asylum seekers and disadvantaged Australians in urgent need of care. Occasionally we also need volunteer dental assistants to assist other private dental practices who are running their own volunteer day.

Please sign up to be on our list of volunteers who stand ready to give their time and expertise to help those in need.

* Please note, you must have at least 2 years of clinical experience to participate in the program.

Personal Details

First Name*

Last Name*

Email*

Phone*

Your location*

Suburb*

Post Code*

State*

Professional Details

Qualifications*

Attach your CV here (MS Word or PDF)*

Number of years clinical experience* (minimum 2 years experience to participate in the program)

Please provide a short work history including date, position, and employer:*

What are you hoping to gain from volunteering?*

Have you volunteered for clinics at ADA NSW or with ADHF? Please provide details including the year you volunteered.?

What languages do you speak other than English?

When we run clinics we provide catering, therefore do you have any dietary requirements?

Do you have any additional support needs or require specialised PPE that we should be aware of. For example, non-latex gloves, tie masks, etc.

Notice and consent

Filling the Gap is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide services you requested from us. From time to time, we would like to contact you about our services, as well as other content that may be of interest to you.

Read our Privacy Policy.

Check here if you consent to allow Filling the Gap to store and process the personal information submitted above to provide you the service requested.