Please complete this application form if you are interested in becoming a Bryan volunteer. Once you complete the form, click the Continue button at the bottom.


ALL ABOUT YOU


EMERGENCY CONTACT


TELL US MORE


OTHER INFORMATION


YOUR RIDE


REQUIRED TO CONDUCT SCREENINGS


COMPLETION OF THIS SECTION IS VOLUNTARY

Bryan Volunteers and Customer Care utilizes this information to compile reports. Please mark all that apply.



Volunteer Statement

• I wish to donate my services to Bryan and understand there is no payment for services rendered as a volunteer at Bryan.

• I understand that confidentiality must be maintained concerning patient information.

• I agree to abide by the rules, regulations, and policies of Bryan Health, Volunteers and Customer Care (VCC) and the department in which I serve.

• I understand that if I do not abide by the rules, and policies of Bryan Health, VCC, and the department in which I serve, that corrective action may be taken, I may be terminated from the volunteer program, and it may result in legal action.

• I understand that Bryan Health may take photographs of me for publications or other uses.

• I authorize the VCC department staff to investigate all statements made in these application forms.

• I authorize the VCC department to complete background check from various Federal, State, Local and other agencies prior to and at any time during my volunteer service at Bryan.

• I understand the VCC department staff will not provide me a copy of the information obtained from the background checks performed. The VCC department will provide me the names of reporting agencies should I wish to make an inquiry.

• I authorize the VCC department staff to verify any license or certification required for my volunteer service.

• I do hereby agree to forever release and discharge Bryan, its agents and employees, to the full extent permitted by law from any claims, damages, losses, liabilities, costs and expenses, or any other charge or complaint arising from the retrieving and reporting of information.

• If applicable, I authorize VCC the right to access my background checks and immunization history from Bryan College of Health Sciences during my volunteer service at Bryan.