Volunteer Application

Dear Potential Volunteer,

Please take your time to complete the application below. Since we receive numerous applications, it will take time to respond back to you.

*Asterisk indicates required field.

Applicant Information

Prior or Existing Work or Volunteer Experience: Please include occupation/title/volunteer experience, organization, and years experience.

Availability

Please include all times that you are available to volunteer (e.g., 8am-12pm, 12pm-4pm, 4pm-8pm) so we can best coordinate with your schedule. (Note that shift availability may vary based on hospital location and specific departments.)

Emergency Contact

Reference

Application Agreement

I certify that all information I have and will provide throughout the selection process, including on this application and in interviews with Henry Ford Health (HFH), is true, correct, and complete to the best of my knowledge. I understand that information I provide may be verified and references may be contacted by HFH. I understand that misrepresentations or omissions may be cause for my immediate termination as a volunteer.

Volunteer Agreement Statement

I am not credentialed or authorized to act as an agent or employee of Henry Ford Health. I will not receive any compensation or benefits, including but not limited to, worker’s compensation. I have not been given a promise of employment in return for my volunteer work. I have not been coerced and am doing this entirely of my own accord. Any hours I volunteer will be in accordance with a schedule mutually developed by me and the Volunteer Department. I am required to comply with the Henry Ford Health’s policies/procedures, including but not limited to, confidentiality, harassment, disruptive behavior, nicotine and substance abuse, dress code and not to impose religious or other beliefs or values on patients, Henry Ford Health staff, families, or other volunteers. I will comply with the Confidentiality Statement that I have signed. Henry Ford Health and I each have the right to terminate my volunteer relationship at any time. I will be considerate of others and conduct myself in a courteous and professional manner and fulfill my commitment by completing all assignments to the best of my ability. I will comply with a background check and initial/annual health screening requirements and complete all health testing required by Employee Health to become a volunteer.

Parental/Guardian Permission for Application

This section is required for any person under the age of 18.

I agree that my child (or ward) may participate in the Henry Ford Health (HFH) Volunteer Program. I have read and understood all the Volunteer information provided. I will be responsible for transportation of my child to and from assignments and events.

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