Dear Member, Please complete this form if you are interested in:
1. Serving on a 2026 SSVMS Committee;
2. Remaining a member of a current Committee in 2026;
3. Volunteering for community service opportunities.

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* 1. Name

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* 2. Specialty

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* 3. Email

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* 4. SSVMS Committees (select the committee(s) you are interested in serving on):

Community Service Opportunities

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* 5. PUBLIC COMMENT: The County Boards of Supervisors and other local bodies have regular public comment periods during their meetings. Check below if you're willing to do public comment regarding public health matters.

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* 6. COMMUNITY LIAISON: We are frequently asked to locate physicians willing to serve on commissions, committees and task forces representing the Medical Society. Check below if you would be interested in volunteering regarding the following topics.

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* 7. MEDICAL MUSEUM VOLUNTEER

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* 8. MENTORSHIP IN MEDICINE

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* 9. FUTURE OF MEDICINE PHYSICIAN HOST

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* 10. SPEAKERS' BUREAU: Occasionally, SSVMS is asked to locate physicians willing to speak to community organizations on medically related topics. Please list topics you specialize in presenting:

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