Dear Potential Volunteer:


Thank you for your interest in volunteering at Carolinas Rehabilitation. Volunteers are an important part of our team that make a difference in the lives of our patients and their loved ones.


Volunteers are required to be 15 years of age or older to serve at Atrium Health. Carolinas Rehabilitation offers volunteer experiences in rehabilitation nursing, therapy, recreational therapy, guest services, and more.


Year round volunteer program

We ask you to commit to a minimum of 100 hours of service, preferably working the same shift/position each week.


If you feel you will be able to meet the requirements above please complete this application form if you are interested in becoming a Carolinas Rehabilitation volunteer. Once you complete the form, click the submit button at the bottom. You will receive a confirmation email after submission.




Name and Contact Information


Demographic Information


References

Please list two references we may contact. Email address is required. (Do not use relatives or current Carolinas Rehabilitation teammates)


High school students (including new high school graduates), you will need to provide 3 references - two of the references must be from school officials.



Emergency Contact

In the case of emergency, who may we contact?



Availability and Volunteer Interests

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


Please note: Therapy volunteers serve between the hours of 8am - 4:30pm; Saturday positions are limited.



Site Preference

Please indicate which site you would most like to volunteer in the space provided below. If desired you can choose to volunteer at multiple sites. Inpatient rehabilitation hospital locations include:


Carolinas Rehabilitation-Charlotte

1100 Blythe Blvd.

Charlotte, NC 28203


Carolinas Rehabilitation-Mount Holly

275 Beatty Drive

Belmont, NC 28012


Carolinas Rehabilitation-NorthEast

487 Lake Concord Road

Concord, NC 28025


Atrium Health, Pineville Rehabilitation Hospital

10648 Park Road

Charlotte, NC 28210

Phone: 704-667-8000


We also offer volunteer opportunities at our outpatient therapy clinics.



Background Disclosure

Atrium Health obtains arrest and conviction records on all potential volunteers. An arrest or conviction will not automatically eliminate you from consideration for volunteering. However, failure to list all pending charges and/or convictions may lead to your disqualification or termination of volunteering with Atrium Health.

Examples may include, but should not be limited to: driving while impaired, worthless checks, assault, driving while license is suspended, disorderly conduct, credit card fraud, embezzlement, etc.


Have you ever been convicted of any criminal violation of law, or are you now subject to a pending investigation of charges for violation of criminal law?


Please list yes or no in the box provided below. If yes, please explain.



Volunteer Agreement

As a volunteer I agree:


I will consider as confidential all information which I may hear or see, directly or indirectly, concerning a patient, patient family member, doctor, or other health care professional and I will not seek information from any of the above in regard to a patient.


I hereby certify that, I the potential volunteer, have provided the answers on this application and any resulting from interviews are true and correct and that any misrepresentations or omissions of facts, misleading, or false information on my part will be grounds for dismissal as a volunteer. Acceptance as a volunteer is contingent upon satisfactory references, verification of information submitted on the application and satisfactory completion of mandatory requirements. I authorize that all employers, schools, or references thus contacted be released from all liability in answering questions related to my application.


My services are donated to Atrium Health without contemplation of compensation or future employment and given with humanitarian or charitable reasons.


I authorize Atrium Health to administer emergency medical treatment to me while volunteering if needed. I understand that Atrium Health is not responsible for volunteers after their assigned volunteer shift has ended even if the volunteer is still on the premises.


The first 90 days of the volunteer experience will be mutually probationary.


Opportunities for volunteers are provided without regard to religion, creed, race, national origin, age or sex.


**Please Note**

By checking 'I agree' this serves as your (the potential volunteer) signature and approval of the statements in this volunteer agreement. Filing an application does not assure volunteer placement since the number of applicants usually exceeds the number of available openings. The Volunteer Services Department is not obligated to provide a placement, nor are you obligated to accept the position offered. All applications are held for 90 days.