Please complete this application form if you are interested in becoming a MUSC Medical Center volunteer Patient & Family Advisory Council Volunteer.


Once you complete the form, click the submit button at the bottom. Applications will be screened, and selected candidates will be called in to interview. Please allow two weeks for this process. We are not able to place all applicants into the program.


Thank you for your interest in volunteering at MUSC!


Name and address


Education


Volunteer Experience


Personal Information


Please indicate if you are/were a:


Council Interest


Involvement


Involvement


We would love to know


Which services have you used at MUSC Health Center


Referral Information


References

Please print names, addresses and telephone numbers of two people we may contact who have known you for more than one year (excluding relatives and roommates).



Statement of Understanding

I certify that all statements made in this application are true. I understand that the Medical University of South Carolina reserves the right to accept or reject my application in its sole discretion.


I understand that volunteers must be at least 18 years of age (and age 21 in some areas of the medical complex) for our adult program. I understand that junior volunteers must be at least 14 years of age for our junior program.


I understand that I will be required to present my immunization records to the Employee Health Office in order to be "cleared" to volunteer.


I understand that I will be required to have a health screening (free of charge) at Employee Health Services.


I will be required to provide an oral history of chicken pox and written verification from my personal physician of: two MMR vaccines (measles, mumps and rubella), a *PPD skin test within 3 months, and a tetanus shot within 10 years. Volunteers assigned to clinical areas must provide proof of Hepatitis B vaccination.


By checking "I Agree" below, I agree to a criminal background check and to a commitment of 100 hours of volunteer service per calendar year.