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

NAME AND ADDRESS


PERSONAL REFERENCE


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.


EMAIL PREFERENCES

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.


PHYSICAL/MEDICAL BACKGROUND


IN CASE OF EMERGENCY


EMPLOYMENT/EXPERIENCE/EDUCATION


AVAILABILITY

Please indicate the days and times you are usually available to volunteer.


WHY DO YOU WISH TO VOLUNTEER?


SERVICE WITH BANNER


COMMENTS


VOLUNTEER COMMITMENT TO SERVICE & CONFIDENTIALTY

Believing that Banner Health has a real need for my services as a volunteer, I agree to:

(1) Hold as absolutely confidential all information which I may obtain directly or indirectly concerning patients, doctors, or personnel, and I will not seek confidential information in regards to a patient;
(2) Uphold the mission, Vision, Values, and Service Standards of Banner Health;
(3) Endeavor to make my work the highest quality;

I understand that my services are donated to Banner Health without contemplation of compensation, or future employment and given for humanitatian or charitable reasons. I verify the preceding information on this application is true. I understand that there are many types of volunteer oportunities with Banner Health facilities, and that i will be required to complete an orientation, complete the employee/volunteer health screening, and additional training that service agreements will require.