Orientation Forms

In addition to the forms completed during your appointment with Volunteer Services, there are five (or six) online forms to complete.

Please read the five (or six) online forms thoroughly. After you have read the forms, please complete the requested information and click "Submit."

*Please note that when submitting multiple Online Forms, the previous Online Form may reappear, but it has been received.

All forms must be submitted before volunteering. If you have any problems with either type of form, please don't hesitate to contact the Volunteer Office.

Online Forms

Background Check

CLICK HERE to access the form required to authorize your police background check.
This is required of all Volunteers OVER 18 Years Old.

Confidentiality Agreement

CLICK HERE if you cannot view the Confidentiality Agreement below, and it will open in a separate tab. You will still need to acknowledge reading and agreement to the Confidentiality Agreement.

Health Screening Form (OVER 18 Only)

* Indicates required field

Name *

First

Last

Email *

Your Primary Care Provider's (PCP's) Name *

First

Last

PCP's Phone Number *

Have you had Chicken Pox as a child or adult? *

If you KNOW you have NOT had the Chicken Pox, have you had the two-dose Varicella vaccination? *

Have you had the Measles as a child or adult? *

If you KNOW you have NOT had the Measles, have you had the Measles vaccination? *

Have you had the Mumps as a child or adult? *

If you KNOW you have NOT had the Mumps, have you received a Mumps vaccination? *

By clicking the Submit button below, I am verifying that the information above is correct. *

Verified as correct

Submit

Medical Awareness Form

* Indicates required field

Name *

First

Last

Email *

Please check any of the conditions you may have so that we may ensure you are not placed in an area that might compromise your health. This information will ONLY be used in the event of an emergency and will be kept strictly CONFIDENTIAL. *

For ALL items checked above, please include required medications and dosage. If you selected NONE, please type NONE in the box below. *

Please list any known drug allergies. Please enter NKA if you do not know of any drug allergies. *

Submit

Influenza Survey
(Required ONLY when starting October - March)

* Indicates required field

Name *

First

Last

Email *

Do you have a SEVERE allergy to eggs or other vaccine components? *

Yes No

Have you ever had Guillain-Barre Syndrome within 6 weeks after a previous influenza vaccination? *

Yes No

Vaccination Status: *

If vaccinated at another location, please provide the location name and date of vaccination: *

Submit

standards_of_conduct_booklet.pdf
File Size:	23927 kb
File Type:	pdf

Download File

Miscellaneous Forms
(Just In Case You Need Them)

background_check_form.pdf
File Size:	84 kb
File Type:	pdf

Download File

new_volunteer_checklist.pdf
File Size:	11 kb
File Type:	pdf

Download File

healthcare_worker_tb_risk_assessment_for_volunteers_-_sept_2017.pdf
File Size:	167 kb
File Type:	pdf

Download File

confidentiality_statement_-_volunteers_form.pdf
File Size:	19 kb
File Type:	pdf

Download File