Dear Future Volunteer:

Thank you for your interest in becoming a volunteer with University Hospitals Elyria Medical Center. Volunteering offers an opportunity to make a meaningful difference in the lives of others, meet great people, and have fun. Our volunteers are a valued extension of the staff and play a vital role in helping to provide expert care and exceptional caring to the community we serve.

Please complete this online application carefully and completely. We will use the information you provide to assist us in identifying the area of volunteer service that best utilizes your skills and talents.

Once you submit your online application, your references will be contacted and you will be invited to attend a volunteer orientation. Please feel free to call Volunteer Services at 440-329-7362 should you have any questions.

General Information

About You:

Help us get to know you better by telling us why you are interested in volunteering. Together we can identify the volunteer opportunity that will best utilizes your skills and abilities. Please note that several roles have age and skill minimums.


Please indicate the location where you are interesting in volunteering. Volunteer opportunities vary depending on location.

Are any family members currently employed by UH?



Please provide the names of three (3) ADULT references (excluding relative, doctors, or teachers) that can be contacted Monday-Friday between 8:00am and 4:00pm.

Skills and Interests

Emergency Contacts

Should an emergency happen while you are volunteering, who should be contacted?

Criminal History

Volunteers are required to have a Federal and State background screening. Prior to your screening, please answer the following questions: Have you ever been convicted of a

Afformation of correct information:

By signing this application, I swear and affirm that I have never been convicted of a criminal offense other than a minor traffic offense. I understand that any misleading or any incorrect statements may render this application void and would be cause for immediate dismissal in the event of placement and expressly release the hospital from any and all claims which might arise out of service as a volunteer.