Please complete this application form if you are interested in becoming a part of CHI St. Joseph Health Pet Visitation Program - Caring Canines. Once you complete the form, click the submit button at the bottom.


Requirements to participate in Caring Canines

To participate in our Pet Visitation Program - Caring Canines. Please acknowledge that you have reviewed and will be able to comply with the following (complete list of policies and procedures is available through Volunteer Services):


To become a CHI St. Joseph Caring Canine volunteer you agree to also be an Aggieland Pets With A Purpose (APWAP) volunteer. It will be necessary for your dog to go through their evaluation process and to be registered with them in order to visit patients on CHI St. Joseph Health premises. Their website is: http://apwap.org/



Contact Information


Demographic Information


Pet Information


Credentials

Please list all education, training and certifications that you and your pet have completed along with dates of completion.



Availability

Please indicate the days and times your are usually available to volunteer.



Skills Assessment

As we prepare to look for your ideal volunteer opportunity, take a few minutes to assess your skills.

What are you good at?

What comes easy for you?

What aspects of your professional life might be assets to our organization?

What personal or interpersonal talents do you have?

Check all that apply.



Assignment Preference

At this time, Pet Visition - Caring Canines, is available for visitation on Pediatrics, Oncology, Telemetry, Cancer Center, Medical floors, and our Assisted Living facility.



Emergency Contact

In the event of an emergency, whom should we notify?



CHI St. Joseph Health Volunteer Information Center

We provide an online "Volunteer Information Center" where volunteers may check their schedules, find out how many hours they have, update their information, and receive messages. **Note** an email address is required to have access to this system.



Background Check

We consider the safety and security of our patients to be of the utmost importance. Applicants must complete a background screening for criminal histories by state and/or federal agencies. Persons who have been convicted of any felony offense or misdemeanor offenses involving drugs, adult/child abuse, assault or any violent behavior are not eligible to volunteer at CHI St. Joseph Health. There are no exceptions. By checking, I agree, at the end of this application, you consent to the background check and attest that you have not been convicted of a felony or misdemeanor as stated above. If you have ever committed, been convicted of, pled guilty to, or pled nolo contendo to, a felony or misdemeanor, please explain.



I Agree ...

I understand and agree that submitting this application form does not automatically register me as a CHI St. Joseph Health Caring Canine Volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies, completion of orientation requirements and procedures before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and accurate and I have not been convicted of a felony or misdemeanor involving drugs, abuse and/or an act of violence.