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Volunteer Services Application Form

Volunteer Services Application Form

Identification Information (Please list your legal name)

If you have an alias, nickname or change of name due to marriage or divorce please let us know.

Emergency Contact

Experience, Skills and Interests (tell us about yourself)

There are criteria and physical requirements for each position. We will try our best to assign you to and available position that will accommodate your skills, and will be mutually beneficial to you and the Auxiliary/hospital. We will discuss possible placement options with you before we assign you to a position.

If yes please list:

Conviction Record (This must be completed to be considered for volunteering)

At Paradise Valley Hospital we require all Volunteer prospects to take a Background check. Before this application is given.

Agreement:

  • I understand I will be asked for government issued ID to verify my identity, and authorize agencies and persons contacted for reference or background information to release information.
  • I understand any misrepresentation or material omission of information in this application may be a cause of dismissal from the Volunteer Program.
  • I understand that the Auxiliary cannot guarantee a position, and that there are qualifications, requirements, competence and physical criteria for positions. The Volunteer Program will try its best to find me a position that meets my skills/needs and that of the hospital.
  • I understand that state and national hospital regulatory agencies require that persons working/volunteering in a hospital setting receive Annual Essentials, Code of Conduct, HIPAA Privacy Legislation that are included in this application and have an annual TB test. We require for all applications to obtain a Health clearance from our Employee Health Nurse. Office hours for our Employee Health Nurse are Monday-Friday 7:00am - 3:30pm; 619-470-4169.
  • I agree to read, abide by the policies and procedures, expectations, ethics customer service standards as presented in the mandatory training and orientation and to perform the duties expected of me to the best of my ability
  • I understand that I donate my services to the hospital without contemplation of compensation or future employment.
  • I understand that my volunteering opportunity may be terminated at any time for any reason as a result of: failure to comply with policies and regulations; absences without notification; unsatisfactory attitude, performance or appearance; or any other circumstance, in the judgement of the coordinator that would make my services as a volunteer contrary to the best interest of the Auxiliary and/or hospital.
  • I agree to make an effort to fulfill my commitment, be punctual and conscientious and conduct myself with dignity, courtesy, and consideration of others.