Please complete this application form if you are interested in becoming a volunteer at UnityPoint Health - Trinity. Once you complete the form, click the submit button at the bottom. Once your application has been submitted you will receive an email within 3 days for further instruction. Completion of application does not guarantee placement.

**Please note - All Volunteers at UnityPoint Health - Trinity are required to be Covid vaccinated, and proof of vaccine card is required for placement. Flu shot is also required during flu season.**

Contact Information


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

Skills & Experience

In the section below, please summarize any relevant skills and experience that exemplify your background, including other volunteer or work experiences, patient care situations, computer/equipment skills, hobbies, and any other special qualifications, capabilities or interests you may have. You make also want to include any other languages you are fluent in (read, write and/or speak).


Please fill out the boxes below with two references (who are not related to you) who know you well and can answer questions regarding your character and abilities.

Emergency Contact

In the event of an emergency, please list two people that we can contact.

Special Projects or Events

Are you willing to assist with special hospital projects or events outside of your regular volunteer hours?


Please let us know why are you interested in volunteering at UnityPoint Health - Trinity.

How did you hear about us?

Please let us know if it was an individual, posted flyer, social media or newsletter article that encourage you to apply.

Background Check & Criminal Conviction

All volunteer applications will be submitted to a criminal background check, per hospital policy. By checking this box, you indicate that you have NOT been convicted of a crime AND that you do NOT have a record of founded child or dependent adult abuse.