Please complete this application form if you are interested in becoming a Flagstaff Medical Center volunteer. Once you complete the form, click the submit button at the bottom.

Name and address


Availability

Please indicate the days and times you are usually available to volunteer. Remember that FMC requires a four hour per week commitment.


Preference

Please select your top three area preferences.


Volunteer Profile/Screening

Please answer the following questions before submitting your application. Put answers in box at bottom of this section.
1. What motivates you to volunteer at Flagstaff Medical Center?
2. What do you expect to learn/goal/purpose from volunteering? What would make you feel that you’ve been successful?
3. What are your interests (in terms of volunteering)?
4. What are your skills you can provide to volunteering?
5. Describe your ideal supervisor. What approach to supervision do you find most helpful?



Email Preferences

We keep volunteers informed of important news and volunteer opportunities by email.


Education

Please provide us with your education.


Work History

Please provide us with work history.


References


Emergency Contact


Please read carefully before signing

VOLUNTEER COMMITMENT TO CONFIDENTIALTY AND SERVICE
If I am accepted as a volunteer at Flagstaff Medical Center, I agree to:
(1) Hold as absolutely confidential all information which I may obtain directly or indirectly concerning patients, doctors, or staff, and I will not seek confidential information in regards to a patient.
(2) Uphold the Mission, Vision and Values of Flagstaff Medical Center
(3) Endeavor to make my work the highest quality.

I understand that my services are donated to Flagstaff Medical Center without contemplation of compensation, or future employment and given for humanitarian or charitable reasons. I verify the preceding information on this application is true. I understand that I will be required to complete an orientation, background check (adults only), complete the employee/volunteer health screening, and additional training that service assignments will require, including annual mandatory training.