Please complete the volunteer application form for consideration into University Health System Volunteer program. Once you complete the form, click the submit button at the bottom. We do not accept court appointed referrals.

Name and Address

Fill in your full legal name below. This information will ensure the accuracy of processing your background check as part of the volunteer application process.


Personal Information

Enter your valid Social Security number for identifier purposes. Applications without a valid Social Security number will not be processed. Our Volgistics database has security measures in place to keep your information safe.


Contact in Case of Emergency


Referral Source

How did you learn about our University Health System Volunteer Program? Please name the source.


University Health System Programs

Please check the following University Health System programs you have participated in:


Additional Availability

Please check your availability to volunteer with Children Health at University Hospital. The approved volunteer time is 9:00am-8:00pm Monday -Sunday.


Child Life Volunteer Guideliness

Child Life Volunteer Responsibilities
• Straighten and organize playspaces
• Interact with patients in playroom or at bedside
• Clean toys
• Special projects and preparation for upcoming events
• Assist Child Life and nursing staff with needs
• Keep a watchful eye on playspaces and have an awareness of all persons in the playspaces
• Participate in patient activities
• Support patients, families, and staff
• Communicate with Child Life Staff

Department Guidelines
• Volunteers must communicate with coordinator about scheduling and adhere to agreed times.
• Volunteers are not allowed to come to unit outside of the scheduled times unless discussed with coordinator prior to arrival.
• Volunteers are required to complete a minimum of two hours in a two-week period and a maximum of 6 hours per week. (Unless otherwise discussed with coordinator)
• Volunteers who miss two volunteer sessions consecutively without communicating with the Child Life Department, will be removed from the schedule and their spot may be given to another volunteer. The volunteer must then communicate with the coordinator again to determine if a new time slot may be acquired.
• Volunteers who miss four volunteer sessions consecutively even while communicating with the Child Life department, will be removed from the schedule and their spot may be given to another volunteer. The volunteer must then communicate with the coordinator again to determine a new time slot that will better accommodate the volunteer’s personal schedule.
• Volunteers may not visit with patients outside of their scheduled volunteer times or outside of the hospital. This includes social media.
• The coordinator may require a volunteer to complete a new Child Life Orientation if the volunteer has not volunteered in more than 90 days.
• To request a personal letter of recommendation from the Child Life Department, a volunteer must complete 100 hours volunteering with Child Life.


References

Please provide us with two references (employer, volunteer manager, etc.). Please indicate any volunteer work experience and provide your supervisor’s name and information.


School Information

Please submit proof of current school enrollment to the University Health System Volunteer Services.


Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however we 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.


Application Disclosure

Your date of birth is requested only for the purpose of obtaining a consumer report. Your response to the requested information is voluntary, and refusal to provide the information will not subject you to any adverse treatment. Your assistance in providing the information on this form will be greatly appreciated and will be kept confidential. Please be advised that this form will be separated from, and is not a part of, your official application for volunteer acceptance.

Note: A consumer report may consist of employment records, education verification, licensure verification, driving history,previous address, and other public records relative to criminal charges. A credit report will not be requested unless it is deemed pertinent to the functions of the position for which you are applying.

I have read the above notice and understand what it means. I hereby authorize the procurement of a consumer report for volunteer purposes. Pursuant to the requirements of the Fair Credit Reporting Act, notice is given that a consumer report may be made in connection with your application for acceptance.

If you are denied, either wholly or partly, because of information contained in a consumer report, a disclosure will be made to you of the name and address of the consumer reporting agency making such report. You will also receive a copy of the report and a statement of your consumer rights.


Volunteer Application Acknowledgement

I HEREBY CERTIFY that all the information provided on this application is true, correct and complete. I grant University Health System permission to verify this information for the purpose of determining my volunteer acceptance. I understand any misrepresentation or omission of any facts necessary to make this application complete shall be cause for rejection of the application or dismissal by University Health System.

I understand this application is not intended as a job offer or a contract for any specific time period and that I may resign or be terminated at any time without notice or requirement of cause.

I understand and agree that, as a condition of acceptance, I will be required to successfully complete all acceptance requirements. I further agree to abide by all rules, regulations, and policies of University Health System if accepted. I understand any acceptance is contingent upon successful completion of background check and health screening. I understand, if accepted, I will be required to complete an annual health screening.

Notice of Controlled Substance and Nicotine Testing Policy:
University Health System conducts its operations with the highest possible degree of safety for acceptance. Because of this standard, University Health System requests that all final candidates for acceptance undergo screening for controlled substances and nicotine.

The screening for controlled substance and nicotine will not be performed without the written, signed consent of the volunteer. A volunteer who decides not to submit to a screening for controlled substances and nicotine, or who does not successfully complete this screening, will not be further considered for acceptance.

By clicking I Agree, I am accepting the conditions and requirements as stated in the Volunteer Acknowledgement and Application Disclosure statements listed above.