Hospice Volunteer Application

Hospice Volunteer Application

Please fill out the below application if you are interested in becoming a hospice volunteer, and a member of our team will follow up with you. Thank you!

Hospice Volunteer Application

Name *

First

Last

Date of Birth (MM/DD/YYYY) *

Email *

City *

Zip Code *

Why are you interested in becoming a hospice volunteer? *

What skills, training, experience, hobbies or interests do you have that might be helpful as a hospice volunteer? *

What type(s) of volunteer services are you interested in providing? *

• Direct Patient
• Care Activities
• Office Support
• Veteran Support
• Bereavement Support
• Other

Preferred day(s) to volunteer: *

• Sunday
• Monday
• Tuesday
• Wednesday
• Thursday
• Friday
• Saturday

Preferred time(s) to volunteer: *

• Morning
• Afternoon
• Evening

Best way to contact you to arrange a time to talk about volunteering? *

• Email
• Phone

Best time to call:

Submit

All volunteer candidates must pass a drug and background check prior to beginning service with our organization.  Our agency will cover the cost of both the drug test and the background check.