Dear Volunteer,



Welcome & thank you for your interest in becoming a volunteer at the University Medical Center of El Paso. We look forward to your energy and enthusiasm that volunteers, such as you, add to the service we provide to our patients.


Like any new undertaking, there are some details that need to be accomplished before starting as a volunteer. Please take the time to read this letter thoroughly  it will make the process easier for you. The following requirements must be met before beginning your volunteer assignment:


* Fill out a Volunteer Services Application.

* Interview with Cristina Cruz Ramirez (We will call you once your application is reviewed).

* Read and sign the Volunteer Guidelines

* Authorization to Perform a Criminal Background Check forms (Will be given to you during your interview).

* A TB test and lab work (These procedures will be done at the University Medical Center of El Paso at no charge to you).

** TB tests are done in Occupational Health located on the second floor of the Annex. If you have not had a TB test in more than one year they will perform the test on you twice.

** Three days after the test is performed you must go back to Occupational Heath and have the test read.

** Lab work including a test for Rubella, Rubeola and Varicella and Titers will be performed in the Outpatient Laboratory located behind the Annex.

* A copy of your shot record if possible.

* Two reference forms (can be obtain at www.umcelpaso.org under volunteer application) to be completed by co-workers, supervisors, professors, family friends etc. Please have the person completing the form fax or mail it to the number/address indicated on the reference form. Do not include reference forms filled out by family members.

* Hospital Orientation (Do not attend orientation until after you have interviewed with the Supervisor of Volunteer Services)

* Must commit to three months of service and a minimum of 100 service hours


All forms must be received in our office before Orientation is scheduled. Orientation is on a Saturday once a month. Orientation is mandatory in order to volunteer. Please bring a pen and paper. You may park in the garage located in front of the hospital.


After Orientation you may schedule a clearance appointment with me to receive your ID badge and uniform. A $15 fee for the uniform and a $5 deposit for the ID badge is required to receive the uniform and badge that must be worn at all times while volunteering on the hospital premises. The $20 deposit will be returned to you after you have completed your volunteer assignment and have returned the uniform and ID badge.


An official background check will be conducted on all volunteers prior to being accepted into the program. There is no cost for the background check. As a volunteer, your accumulated hours for service, does not translate into internship or externship hours.


Im looking forward to working with you and helping you enjoy your time with us. Again, thank you for making us your choice for your volunteer experience!



Cristina Cruz Ramirez

Supervisor, Volunteer Services



Name and address

THE INFORMATION THAT I'M ABOUT TO PROVIDE IS ACCURATE AND CORRECT TO THE BEST OF MY KNOWLEDGE.


I UNDERSTAND THAT I AM PROVIING SERVICES STRICTLY ON A VOLUNTARY BASIS AND THAT I HAVE NO EXPECTATION OF COMPENSATION.

IF PLACED IN A VOLUNTEER POSITION I WILL COMMIT TO A MINIMUM OF 100 HOURS OF SERVICE.



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.




Availability

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



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.



References

Please provide us with three different references could iclude family members, friends, co-workers, teachers and neighbors



Emergency Contact

In case of an emergency, please notify:



Training/Skills:

What previous training, experince, or skills do you think you bring to the organization?



Criminal Background

In connection with your application for volunteer service, University Medical Center of El Paso may conduct a detailed investigation of your credit history, criminal history, employment history, educational history, and background. As part of its investigations, the University Medical Center may obtain consumer reports from consumer reporting agencies. Under the Fair Credit Reporting Act (“FCRA”), University Medical Center is required to obtained your authorization prior to procuring such consumer reports.

------------------------------------------------------------------------------------------------------------------------

I have read the above guidelines, I will abide by them and I hereby authorized University Medical Center to conduct an investigations of my credit history, criminal history, employment history, educational history, and background, which may include, but may not be limited to, procuring consumer reports from consumer agencies understand their importance.



Criminal Background:

1. Have you ever pled guilty, no contest (nolo contender), entered into a deferred adjudication, been convicted of a crime (other than a minor traffic offense) which has not been removed/dismissed by the court or do you have any related items pending with the Court System? (Before you answer, please note that a conviction or plea of guilty will not necessarily be a bar to employment.)



.

If answered yes or pending, to the question above, please give full details, including dates.



Ethics Guidelines

When accepted as a hospital Volunteer:


1. Being a hospital volunteer carries the responsibility of being loyal to the hospital. I understand that hospital affairs are strictly confidential and I am subjected to the same code of ethics which governs the hospital staff. I am expected to comply with the policies and procedures of the University Medical Center of El Paso and the Guest Service Department.


2. My services are donated to the hospital without contemplation of compensation or future employment. I also understand that solicitation for employment while serving as a volunteer is against the hospital. My services are given with humanitarian, religious, or charitable reasons.

3.Upon arrival to the hospital, I will clock-in using my ID badge. When leaving the hospital I will clock-out. I understand that if I forget to clock in or out I must inform the Supervisor of Volunteer Services with-in 24 hours or I will not receive credit for the hours volunteered that day.


4. I am required to provide the history of my past immunizations before the start of my volunteer service. I may be asked to receive a tuberculosis skin test and provide a sample of blood (to check my immunity to chickenpox and measles). Any tests required by the University Medical Center will be provided at no cost to me.


5. I must attend an orientation before beginning my volunteer service. The information provided (including the confidentiality and substance abuse testing policies) during this orientation must be presented to all staff members, including volunteers. I will be required to review this information on a yearly basis. I will also be required to update my tuberculosis skin test annually in order to remain active as a volunteer.


6. I am required to wear a uniform while volunteering. The Supervisor of Volunteer Services will provide dress code information during the orientation. Volunteers are not permitted to wear scrubs.


7. I will report to my volunteer assignment on time and in appropriate attitude. I will be issued an identification badge, which will be used to record my time on the Electronic Time Collection System. This badge must be worn at all times while I am volunteering. It is against hospital policy to use this badge in any manner which it is not intended. I understand that I must return my uniform and badge when I have completed my service.


8. I understand that I am authorized to charge a maximum of $5.80 per day in the cafeteria before or after a four-hour shift on the days I volunteer. If I go over I am responsible for the difference.


9. If I am not able to report at my scheduled time, I will call the department to which I am assigned as far in advance as possible.


10. I shall not sell or attempt to sell goods or service, request contributions or solicit person to sign or distribute literature of any kind on the hospital premises unless I receive the express authorization of the Supervisor of Volunteer Services to engage in these activities.


11. There shall be no loitering in any part of the hospital at any time. I shall not visit friends, patients, or other volunteers except in the line of duty. I will not come to the hospital unless I am volunteering and in uniform. The only exceptions are, of course, if I am a patient or visiting a patient.


12. Any accident, injury or unusual occurrence in which I may be involved while volunteering must be reported to the Guest Services Department Office immediately.


13. I shall attempt to resolve any problems related to my volunteer activities with my supervisor, and, if unsuccessful, attempt to resolve such problems with the Supervisor of Volunteer Services.


14. I will not ask the staff for professional advice for myself or my family while I am on duty. The privilege of being a volunteer does not include free medical service or a reduction in hospital rates.


15. I will not give medications, take vital signs, provide any type of direct patient care or leave the hospital to run errands for patients or associates. I understand that the person in charge of my department or floor is responsible for the section, and I am under his or her supervision. When in doubt as to any procedure, I will consult the supervisor and let him or her take the responsibility.


16. I understand that the following places are off-limits to volunteers: Isolation Rooms, Operating Rooms, Delivery Rooms and the Morgue.


17. By agreeing to become a volunteer, I have made a commitment to provide a service of both my time and ability. I shall fulfill my commitment to volunteer three months for a minimum of 100 hours at The University Medical Center by completing all assignments I accept.


18. As a volunteer, I am eligible to receive a permit to park my vehicle in the employee garage at no cost. This permit is the property of the University Medical Center and may be revoked at any time if abuses of this privilege are reported to the Supervisor of Volunteer Services. I understand that my accumulated hours of service will not translate to Internship or Externship hours.


19. As a volunteer, I may be subject to drug and alcohol testing when a Supervisor or other observers reasonably suspect the individual under the influence.


20. I understand the Volunteer Services Department reserves the right to terminate my volunteer status as a result of:

a. Failure to comply with the policies and procedures

of the hospital.

b. Absence without prior notification.

c. Unsatisfactory attitude, work or appearance; or

d. Any other circumstances which, in the judgment of

the Supervisor of Volunteer Services, would make my

continued service as a volunteer contrary to the

best interest of the hospital.

________________________________________________________________________________________________________________________

I have read the above guidelines, I will abide by them.


BY YOU CHECKING THE "I AGREE" CHECKBOX, YOU INDICATE YOUR APPROVAL FOR US TO CHECK REFERENCES AND CONTACT YOUR PHYSICIAN TO DETERMINE IF YOU ARE ABLE TO PERFORM THE DUTIES OF THE VOLUNTEER POSTION YOU HAVE APPLIED FOR IN A REASONABLE AND SAFE MANNER.


THE ORGNIZATION IS NOT OBLIGATED TO PROVIDE A PLACEMENT, NOR ARE YOU OBLIGATED TO ACCEPT THE POSITION OFFERED.


OPPORTUNITIES FOR VOLUNTEERS ARE PROVIDED WITHOUT REGARD TO RELIGION, CREED, RACE, NATIONAL ORIGIN, AGE OR SEX.


Please indicate your consent by clicking on the 'I agree' checkbox.