Thank you for your interest in becoming a volunteer for Ohio's Hospice of Dayton. Please complete the following application form. Fields with an asterisk (*) are required.

Contact Information

Emergency Contacts

In the event of an emergency who should we notify?


Please list two personal references. References should have personal knowledge of your qualifications to volunteer and can NOT be related to you.

Interest in Volunteering

Briefly explain your interest in volunteering with Ohio's Hospice of Dayton.

Special Skills

Please list any special skills or training you are willing to share with us.

Other Volunteer Service

Please list volunteer service to other organizations in the last five years.

I Agree To The Following Terms:

The following are required to volunteer with OHI:

  1. Criminal Background Check: Required for anyone 18 years of age or older.
  2. 2-Step TB Screening: TB screening or documentation of a TB screening within the last 12 months may be permitted.
  3. COVID-19 Vaccine:  Ohio's Hospice and all related organizations require administration and completion of one of the 3 approved COVID-19 vaccines as a condition of volunteering.  Proof of COVID-19 vaccination or a submitted medical or religious waiver/exemption is required prior to attending orientation.  An exemption must be approved by OHI and volunteer must comply with any stated guidelines and testing.  
  4. Flu Vaccine:  Volunteers are required to either be vaccinated (and provide proof) or provide a medical or religious waiver by December 1 of each calendar year to volunteer during flu season. 
  5. Smoking Policy:  Smoking is prohibited in all facilities used by and partnered with Ohio's Hospice.

OHI retains the right to verify all information provided by me. In the process of such verification, I fully authorize OHI to contact any person, school, organization, or employer listed to disclose all information necessary to verify information or statements. I release all persons who disclose such information from any liability or damages to me or anyone acting in my name. I waive any written notice of the release of such information that may be required by any state or federal law. Any falsification, misrepresentation, or omission, whenever discovered, shall be considered legitimate and sufficient grounds for dismissal.

Volunteering with OHI is at-will. This means that I may stop volunteering at any time. Similarly, OHI may terminate my volunteering at any time, with or without cause.