Thank you for your interest in volunteering with Fairview Hospice. Volunteers are an important part of our care team, and we appreciate your willingness to consider sharing your time and talents with us.


Please complete this application form if you are interested in becoming a Fairview Home Care and Hospice volunteer.

1. Review the application first to make sure you have all the required information available before you start.

2. Fill out the application completely as you cannot return to the form to complete it later.

3. When complete, click the "Continue" button at the bottom.

4. Return to our website and print two reference forms to be completed by your professional references.


Information collected is being transmitted via a secure connection using SSL and will only be used to process your volunteer application.


Name & Address


Emergency Contact Information

In the event of an emergency whom should we contact?



Demographic Information

Information about religion/spirituality may be used to help us match volunteers with patients. You must be at least 18 years old to volunteer.



Employment


Skills & Experience

What qualities (skills, talents, knowledge and experience) do you feel you can incorporate into your hospice volunteer work? Check all that apply.



Availability

A minimum commitment of 50 hours of service is required. We ask that our volunteers give an average of 2-4 hours per week, and the scheduling is quite flexible. Please indicate the days and times you are usually available to volunteer.



Other information for Volunteer Assignments

To help us match volunteers to their assignments please provide the following information. Check all that apply.



Geographic Areas

Check all cities where you are willing to visit patients:



Terms and conditions for applying

The information submitted in this application is true and accurate to the best of my knowledge. If approved for consideration, I understand I will be expected to abide by the policies and standards of Fairview Home Care and Hospice. Prior to placement in a volunteer position, I understand that I will have to attend a new volunteer orientation, submit a background study form as required by law, and complete a pre-placement interview and health screening.