Please complete this application form if you are interested in becoming a ECU Health Medical Center volunteer. Once you complete the form, click the submit button at the bottom.

Personal information

Emergency contact

Availability and Interests

We need volunteers Monday through Friday from 7 am until 9 pm. Evening and weekend positions are available, but limited. We can discuss this in detail during your interview.

Why volunteer?

If you desire to earn volunteer hours for school or another organization with a special program for credit, please share that as well. We do not accept community service hours.

Email Preferences

We like to keep volunteers informed of important news, schedules and volunteer opportunities by email. We will not, however, send you any emails that you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

Criminal Record Check

Confidentiality Agreement

ECU Health Medical Center has a legal and ethical responsibility to safeguard the privacy of all patients and protect the confidentiality of their health information. In the course of my assignment at ECU Health Medical Center, I may come into possession of confidential patient information, even though I may not be directly involved in providing patient services. I understand that such information must be maintained in the strictest confidence.

Acknowledgement & Release: Substance Prevention

I have been informed and acknowledge that ECU Health and its subsidiary corporate entities have a Substance Abuse Prevention Policy which includes a Zero Tolerance Provision. I understand that applicants for positions with these corporations may receive pre-employment drug screening as part of the hiring process and that hiring decisions are contingent upon the results.

I specifically consent and agree to provide body fluid samples (blood and/or urine) for drug and/or alcohol screening in accordance with the policy as part of the application process.

I understand that if I am not accepted because of a positive drug screen, I will not be reconsidered for volunteer service at VH or any of its subsidiary corporate entities until I can document twelve (12) continuous months of treatment for drug abuse.

I understand and specifically consent and agree that any positive drug screening results will be furnished to the appropriate Volunteer Department and to my professional licensing board, if appropriate, I further understand that once accepted, subsequent positive screens or refusal to provide samples when requested will make me subject to disciplinary action up to and including termination.

Disclosure/Authorization Statement

Type in the statement