Volunteer Application Form

CONFIDENTIALITY AGREEMENT: I understand that any information that I may obtain directly or indirectly concerning patients, families, visitors, staff, Children’s Hospital & Medical Center, or affiliates will be held absolutely confidential. If I break confidentially of patients and/or families I may be terminated from the volunteer program.

ANNUAL TB SKIN TEST and EDUCATION REVIEW: I understand that I am responsible to complete an annual TB skin test and education review of hospital and service area information.

PHOTO RELEASE: I understand that a hospital representative may take photographs of me for publications or volunteer services use during my volunteer time.

I have read the above statements. I understand the written information and agree to abide by the rules, regulations and policies of Children’s Hospital & Medical Center, affiliates, and the Volunteer Services Department. I understand that if I do not abide by rules, regulations and policies I may be terminated from the volunteer program.