Please complete this application form if you are interested in volunteering as a group at CentraCare Health. Once you complete the form, click the submit button at the bottom. Please note that a 4 week minimum notice is needed to arrange group requests.


Thank you for your interest in visiting our patients/residents/tenants. Connection with the community brings, joy, fun and new experiences for the people we serve.


All visits are arranged and approved by Volunteer Services and the department you will be visiting. Accepted activities include and are not limited to:

• Arts or Crafts

• Bingo

• Dance

• Game or Activity Fair

• Magic

• Music or other performances

• Puppetry

• Reading Poetry or Books

• Sewing / Quilting

• Special Events such as petting zoo

• Theater / Drama


Room to room visits require supervision by staff.



Contact information


More information about your group


Total number of visitors:


Number of visitors age 13 and younger


Number of visitors age 14-17


Number of visitors age 18 and older


Purpose for your visit

Please describe your visit in detail including special equipment/space needed.



CentraCare location you wish to visit:


Date and Time you wish to Visit:


Media* (photos/video/etc.)

Media requires prior approval –see Visiting Group Guidelines. If you are planning media, please describe.



How did you hear about us?


Agreement

I have read and will review with my group prior to our arrival the Visiting Group Guidelines. I also affirm me & my group’s agreement to adhere to these guidelines.