The application will only be considered completed when you have filled in your information and clicked on the SUBMIT APPLICATION button below.
Emergency Contact Information
School and Employment Information
Volunteer Service Information
References and Background Information
Medical History Information
|Please use this space to add any additional comments or information:
Volunteer Applicant's Agreement
- I certify that the information contained in this application is correct to the best of my knowledge.
- I authorize investigation of all matters contained in this application, and agree that any misleading, false or intentional omission of pertinent information would be cause for rejection of my application or cause for dismissal if already placed in the program.
- I understand that the individuals that I have listed as personal references will be asked questions concerning my ability, character and reputation.
- I understand that volunteer placement with UF Health Jacksonville is contingent upon receipt of satisfactory references, background check, health screening and a TB skin test (PPD), as well as satisfactory completion of Volunteer Orientation.
- I understand that initial and continuous volunteer placement is at the discretion of UF Health Jacksonville Volunteer Services.
Additionally, if selected to be a UF Health Jacksonville volunteer, I agree to:
- Should any information I have reported in this application change at any time during the application process or after placement, I understand that I have a duty to report any and all changes to the Volunteer Services Department.
- Abide by the Policies & Procedures of the hospital, the Volunteer Services department and the department and/or program to which I am assigned.
- Keep all patient information and hospital business completely confidential at all times.
- Strictly adhere to the volunteerservice guideline(job description), and be aware of volunteer limits and boundaries.
- Refer any problems, criticisms or suggestions to the Volunteer office.
- Carry out assignments according to the schedule agreed upon, and call in advance when unable to work as scheduled.
- Maintain a professional appearance and demeanor while on duty, and demonstrate courtesy and consideration of others.
- Agree to commit to a minimum of 100 hours of service. (80 for summer student program)
- Donate my services to the organization without contemplation of compensation or future employment.
- Attend orientation and training, and participate in the hospital's ongoing inservice programs as necessary.
- Uphold the mission, vision and values of UF Health Jacksonville.
Type in your name in lieu of your signature:
When you have completed the application, click "Submit Application".
Once the application is submitted, you will see a confirmation screen and have an opportunity to print your application.