Please complete this application form if you are interested in becoming a Augusta University Medical Center volunteer. Once you complete the form, click the submit button at the bottom.

Contact Information


email

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.


Demographics

The following information is only used to help us get a better idea of the demographic make-up of our volunteers.


Skills, Hobbies & Experience

List any skills, training, or hobbies pertinent to the volunteer position desired (ie...clerical, administrative, CPR).


Availability

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


Emergency Contact

In the event of an emergency whom should we notify?


Assignment Preference

Please select your assignment preference.


Employer

Please list your current or most recent employer, if applicable.


Volunteer Experience

Please list previous or past volunteer experience, if applicable.


Reference

Please provide a reference other than a relative.


AU Health Volunteer Agreement

If accepted into the AU Health PFA program, I agree to:

1. Become familiar with the organization’s policies and procedures and uphold its philosophy and standards.

2. Donate my services to the organization without contemplation of compensation or future employment.

3. Hold as absolutely confidential all information that I may obtain directly or indirectly concerning patient and staff and not seek to obtain confidential information from a patient. I will also maintain confidentiality of organizational sensitive information; this includes but is not limited to information, data, reports, analyses, processes, know-how, research, practices, and strategies.

4. Be punctual and conscientious, conduct myself with dignity, courtesy and consideration of others and strive to make my volunteering professional in quality.

5. Attend in-service training as scheduled.

6. Carry out assignments and seek assistance when necessary.

7. I understand that the Patient/Family Advisor Volunteer Service Program reserves the right to terminate my volunteer status as a result of: (a) failure to comply with organizational policies, rules and regulations; (b) any other circumstances which, in the judgment of the Administrative Director, would make my continued service as a patient advisor volunteer contrary to the best interests of the organization.