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


Requirements and Commitments:

We are recruiting volunteers who can commit to a minimum of 100 hours or longer with the availability of one shift per week, more than once per week, or as needed.



Applicant's Information:

Provide the following information. An email is required for future communication(s).



Demographic Information:

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.



Communication Preferences:

To keep volunteers informed of important news, schedules, and volunteer opportunities, messages can be delivered via email, automated text-messages, or both. Please select your communication preferences below.



Availability:

If you are interviewed and offered a volunteer position, your availability to serve as a volunteer is very important. Indicate the days and times you are available to volunteer.



Emergency Contact Information:

Please provide Emergency Contact Information.



Physical and Medical Background Information:

Do you have any physical limitations or medical condition that may limit your ability to perform any volunteer duties? If "Yes", please explain below.



Felony Question:

Have you, under this name or any other name, ever been convicted of a felony? (Excluding any minor traffic violations).



COMMITMENT TO CONFIDENTIALITY AND SERVICES

By checking "I Agree" and submitting my application, I am stating that to the best of my knowledge all information I have provided is true and accurate.

I agree to:

1. Hold as absolutely confidential all information which I may obtain directly or indirectly concerning patients, doctors/nurses, personnel/staff, and I will not seek confidential information in regards to a patient.

2. Uphold Banner's Mission, Values, and Purpose Standards.

3. Endeavor to make my duties as a volunteer the highest quality.


I understand that my services are donated to Banner Health System without contemplation or future employment and given for humanitarian or charitable reasons. I verify that the preceding information on this application is true and accurate. I also understand that there are many types of volunteer opportunities with Banner Health System facilities, and that I will be required to complete all requirements including: Volunteer Health screening, required TB screening at Banner Occupational Health, an annual flu vaccination, Background Check, Volunteer Orientation and training, and annual education.