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

Name and address

First name:

Last name:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Work phone:

OK to call me here

Cell phone:

Email address:

Demographic Information

Date of birth:

Gender:

Education:

Emergency Contacts

First name:

Last name:

Home phone:

Cell phone:

Relationship:

Assignment Preference

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

Why are you interested in volunteering

There are many reasons people choose to serve as a volunteer. What's yours?

Availability

Terms and Conditions

I understand and agree that in the performance of my duties as a volunteer at Sanford Medical Center, I must hold patient information in confidence. Hospital volunteers have an ethical responsibility to protect patient's privacy. Information regarding patients must not be released, disclosed, or discussed either inside or outside the hospital.

There are laws, both state and federal, safeguarding patient records and penalties for the release of confidential information without patient authorization. I understand all may result in punitive action including possible termination, fine or imprisonment.

As a volunteer, I will consider all confidential information that I hear about patients, families or hospital personnel as private. I will preserve family privacy by refraining from questioning staff, children or families about a patient's diagnosis. I will not discuss a patient's medical condition unless the patient or family initiated a discussion.

I certify that the information given by me in this application is true and complete. I understand that any false information, misrepresentation or concealment of fact is sufficient ground for my immediate discharge by Sanford.

I understand and agree that all information furnished in this application may be verified by Sanford. I hereby authorize all individuals and organizations named or referred to in this application and any records repository, or law enforcement organization, to give Sanford all information relative to my employment, work habits, character, credit history and any criminal record and hereby release such individuals, organizations and Sanford from any liability for any claim or damage which may result. I understand that I may inquire as to the identity of those credit reporting agencies contacted and Sanford will advise me of their identity and the nature and scope of information furnished.

I understand upon agreement of this application I will receive an electronic background check and am responsible to complete and return the background check within 48 hours.

I understand and agree that my volunteer services can be terminated with or without cause and without notice at any time at the option of with Sanford or myself. I also understand that volunteers must be at least 17 years of age and that volunteers must wear a volunteer uniform and badge while on duty.

Sanford is an Equal Opportunity Employer and expressly prohibits any form of unlawful volunteer harassment based on race, color, religion, gender, sexual orientation, national origin, age, disability or veteran status. If you have questions or need further assistance, please contact our volunteer office at 701-234-5940.

I Agree