If you are at least 18 years of age or older, please complete this volunteer application for Banner Desert or Cardon Children's Medical Centers. Once you complete the form, click the submit button at the bottom of the application.


APPLICANTS STATEMENT OF UNDERSTANDING

I understand applicants are invited to participate solely at the discretion of staff, and this application does not guarantee a call back, invitation to interview, or an offer of volunteer position.



SCHEDULE COMMITMENTS AND REQUIREMENTS

We are currently recruiting for individuals who can commit to a minimum of 6 months to 1 year of volunteer service, or more serving one regular 4 hour scheduled shift per week. If you are unable to meet the time requirement. Please complete this application at a later date.



NAME AND ADDRESS

An email address is required for future communication.



DEMOGRAPHIC INFORMATION

Please complete the following:



VOLUNTEER SCHEDULE AND TIME AVAILABILITY

If you are interviewed and offered a volunteer position, your availability to serve as a volunteer is very important. What is your availability and schedule preference?



FELONY QUESTION

Have you, under this name or any other name, ever been convicted of a felony or a felony that was reduced for sentencing purposes including DWI/DUI (excluding any minor traffic violations)? If YES, state the offense, disposition:



PHYSICAL and MEDICAL BACKGROUND INFORMATION

Do you have any physical limitations or medical condition, that may limit your ability to perform the duties. If "YES", please explain:



VERIFICATION OF IDENTITY

I agree to provide my date of birth and Social Security number to verify I have not been excluded from participation in any Medicare, Medicaid or other federal health care procurement program.



OIG EXCLUSION

Banner requires all Screening Subjects to immediately disclose if they are currently excluded, debarred, suspended, or otherwise ineligible to participate in Federal Health Care Programs or in federal procurement or non-procurement programs. All Screening Subjects must also immediately disclose if they have been convicted of a criminal offense that falls within the scope of 42 U.S.C. ยง 1320a-7(a), but have not yet been excluded, debarred, suspended, or otherwise declared ineligible.



COMMITMENT TO CONFIDENTIALITY and ONBOARDING

By Checking "I Agree" and submitting my application, I am stating that, to the best of my knowledge, the information I have provided is true and correct. I agree to:

1. Hold as absolutely confidential all information that I may obtain directly or indirectly concerning patients, visitors, physicians, nurses, and all Healthcare Staff.

2. I will not seek confidential information regarding any patient.

3. Uphold the Core Values, Performance Standards, and People Experience expectations of the Banner Health System.

3. Endeavor to serve with compassion, empathy, accountability, responsibility, and excellence.


I understand that my services are donated to the Banner Healthcare System 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 there are many types of volunteer opportunities within the Banner Healthcare System and as a pre-boarding and onboarding, I will be required to complete all Pre-boarding Requirements, including; New Volunteer Orientation (NVO)and, or Department/Unit Training, a Background Check and Occupational Health Screening.

I also understand that for whatever reason, at their sole discretion, Banner Health Volunteer Services reserves the right to withdraw an offer to volunteer and to close my volunteer application.