Please complete this application form if you are interested in becoming a Palomar Health Volunteer. Applicants must be 16 years of age or older (16 to 17 years of age for our Junior Volunteer Program). You will not be able to save the application and return later. Once you complete the form, click the 'Submit' button at the end. A confirmation message will appear after the application has been submitted.
Please note: Fields marked with an asterisk (First name, Last name, Address, Phone and Email) are mandatory.
Administrative Messages are sent by Volunteer Services.
Checklist Reminders are notifications to you about personal credentials which are about to, or have recently, expired. Examples include notifications that your mandatory TB test is due, or that re-certification is required to ensure that a credential remains current.
Use the space below to tell us more about yourself and your interests.
Please provide the following information to help us better understand your skills and background.
Please tell us about your desired level of patient interaction and general availability so that we can match you with our current volunteer opportunities.
Please provide an Emergency Contact. If under 18 this should be your Parent/Guardian.
We ask that our volunteers agree to serve a minimum of 100 hours. All volunteers must be fully vaccinated for COVID-19, pass a background check, and complete an annual TB screen (provided free of charge by Palomar Health), and an annual Safety Test. There is a $50 processing fee which is non-refundable. All volunteers must have a valid email address in order to volunteer.
You are affirming that you are between the ages of 16 to 17 and wish to participate in the Junior Volunteer program. You acknowledge that you will are providing your Parent/Guardian's contact information in the Emergency Contact section above. You will also have your Parent/Guardian read and co-sign the Volunteer Agreement that will be mailed to you. And that the Parent/Guardian will be present for the online Group Interview, the online Volunteering Orientation session, and the TB screen at Employee Health.
By checking this checkbox you agree to all of the above.
I understand and agree that submitting this application form does not automatically register me as a volunteer with Palomar Health, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.
By submitting this form, I attest that the information I have provided in this form is true and accurate.
