Please complete this application form if you are interested in becoming a Parkview Hospice Volunteer

Parkview Hospice asks that volunteers are 18+ and are willing to make a commitment to the program. All volunteers must be willing to complete a background check, occupational health requirements, and all necessary training and orientation. It is recommended that volunteers who have had a recent personal loss wait at least 12 months before volunteering in hospice.

Once you complete the form, click the Continue button at the bottom.


Contact Information


Demographics


References

Please provide two NON-FAMILY MEMBER references that we may contact. NOTE: Valid references (including complete addresses) MUST be included in this field for application to be processed. To expedite the reference process, please provide a valid email address for both of your references.



Emergency Contact

In the event of an emergency whom should we notify?



Why Parkview Hospice?

1. What makes you interested in volunteering with Parkview Hospice? 

2. What skills do you have that you think would fit with our program?



Volunteer Experience

1. Do you have any prior volunteer experience?

2. Do you currently volunteer for any agencies?



I Agree

I certify that the information in this application (and any accompanying documents) is true. I understand that falsification of any information in this application, discovered at any time before, during, or after I begin my position as a volunteer may lead to my termination.


I hereby authorize Parkview Health (Parkview Home Health & Hospice) to verify, obtain copies of records and gather any information pertaining to my submitting a volunteer application with Parkview Home Health & Hospice. My signature on this application authorizes Parkview Health (Parkview Home Health & Hospice) to request written verification as needed.


The receipt of this application does not imply that I will be offered a position as a volunteer. If accepted as a volunteer, I agree to comply with established rules, policies, procedures and Parkview Health Standards of Behavior. This includes but is not limited to those which relate to confidentiality, employment and universal precautions.


I understand my volunteer position with Parkview Home Health & Hospice means volunteering at Parkview's discretion; my volunteer position can be terminated at any time with or without cause, and with or without notice at the option of Parkview Health or myself.


It is the policy of Parkview Health to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual orientation, expression of gender identity, age or disability.


Thank you for completing this form and for your interest in volunteering with us!