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


Requirements and Commitments:

We are currently recruiting volunteers who can commit to 6 months or longer as a BPMC Volunteer with the availability to volunteer 1 regular shift of 4 hours a week. If you are unable to meet any of these requirements at this time, please complete this application at a later date.



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.



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.



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.