Emergency Contact Information

Emergency Contact Name*

Relationship*

Phone Number*

Availability

Preferred Shift Times*

Morning (8 AM - 12 PM)Afternoon (12 PM - 4 PM)Evening (4 PM - 8 PM)

Total Hours Available Per Week*

Volunteer Preferences

Are you looking for short-term or long-term volunteering opportunities?*

Short-Term (e.g., one-time events or projects)Long-Term (e.g., ongoing commitment)

Please describe any previous volunteer or work experience related to healthcare or hospital settings

Health and Safety

Do you have any medical conditions or allergies we should be aware of?*

YesNo

If yes (Please Specify)

Do you have any special needs or require accommodations to perform your volunteer duties?*

YesNo

If yes (Please Specify)

Background Check and Agreement *

I agree to undergo a background check as required by the hospital
I agree to adhere to the hospital’s policies, procedures, and confidentiality agreements
I consent to the use of my photos and/or testimonials for promotional purposes.

I agree all conditions

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WordPress Hospital Volunteer Registration Form

Emergency Contact Information

Availability

Volunteer Preferences

Health and Safety