Please complete this application form if you are interested in becoming a Craig Hospital volunteer. Once you complete the form, click the continue button.

**Please note this is not an internship application. If you have already been accepted as an intern, please complete this form to track your hours.


PERSONAL INFORMATION


EMERGENCY CONTACT


EMPLOYMENT EXPERIENCE


SPECIAL EDUCATION & TRAINING EXPERIENCE


VOLUNTEER EXPERIENCE


DEMOGRAPHIC INFORMATION


AVAILABILITY

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



REFERENCE


INTERESTED AREAS & SKILLS


GROUP LIST


Foundation Mailing List - Opt In

The Craig Foundation supports Craig Hospital patients, programs, and spinal cord and brain injury research. Would you like to receive Foundation news, success stories, event invitations, and giving opportunities?



IMMUNIZATION INFORMATION

As part of the application process for volunteering at Craig Hospital, an Immunization and Infectious Disease Screen must be completed. You must meet the same requirements as employees regarding immunization and infectious disease screening. The goal is to have a safe and healthy environment for our patients, employees, and volunteers. The following items must be provided to Craig prior to attending orientation:


MUMPS, MEASLES, RUBELLA and COVID-19

If you were born BEFORE 1957 and have never had Mumps, Measles and Rubella

OR

If you were born AFTER 1957

You are required to provide one of the following…

• Documentation of MMR vaccine (You must have the date of two separate vaccinations to show immunity)

• Laboratory proof of immunity as evidenced by laboratory positive titers (IgG blood test) for Mumps, Measles and Rubella. You may get this through your physician.

CHICKEN POX

If you have never had Chicken Pox, you are required to provide one of the following…

• Documentation of two Varicella vaccines

• Laboratory proof of immunity as evidenced by laboratory positive titers (IgG blood test). You may get this through your physician.

COVID-19

•  Craig Hospital does require volunteers to have the COVID-19 vaccination.


TUBERCULOSIS

• If you have ever tested positive for or been treated for Tuberculosis, you are required to provide a copy of a negative chest x-ray and a meeting will be set up with Occupational Health Services (OHS).

• If you have NOT had a TB Test within the last 3 months, one will be performed on the day of orientation by Occupational Health Services at no cost to you.

INFLUENZA

During November 1st- April 1st all volunteers must have the flu vaccine.


***AFTER READING THE ABOVE INFORMATION, PLEASE COMPLETE THE QUESTIONNAIRE BELOW (check all that apply)***



IMMUNIZATION AGREEMENT

Immunizations records are required before you start your volunteer experience. You will not be able to volunteer until this is completed.


Immunization records can be obtained from personal resources such as your child health records, laboratory evidence of immunity, previous health care employer, military records, primary care physician office or immigration papers.


Please contact us if you have questions.

Occupational Health Services - ohs@craighospital.org


***I have read and understand the Immunization and Infectious Disease Screen information and have completed the questionnaire to the best of my knowledge. I agree to email a copy of MMR vaccines (if I have never had Mumps, Measles and Rubella or if I was born after 1957), Varicella (if I have never had Chicken Pox) and COVID-19 to ACopilevitz@CraigHospital.org***