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Apply to Volunteer at HealthEast

 

HealthEast Volunteer Application

  1. Thank you for your interest in volunteering at HealthEast. Volunteers play an integral part in our success. Your dedication enhances the care we provide to our patients.

    To apply for a volunteer position, please complete the form below. Once you have submitted this form, you will be taken to a page with a health form and a recommendation form that are both required for your application to be complete.

    Please note: Woodwinds is not accepting applications at this time. Please check back later. Thank you.

    Your application will not be considered until these supplemental materials are returned to HealthEast.

    *Indicates required field

  3. I would like to volunteer at:*
    Please choose a location.
  4. Age*
    Indicate your age range.
  5. First name*
    Enter your first name.
  6. Middle initial
    Invalid Input
  7. Last name*
    Enter your last name.
  8. Date of birth*
    Enter your date of birth.
    mm/dd/yyyy
  9. Street address*
    Enter your street address.
  10. City*
    Enter your city.
  11. State*
    Select your state.
  12. Zip Code*
    Enter your zip code.
  13. E-mail address*
    Enter a valid e-mail address.
  14. Confirm e-mail address*
    Enter a valid e-mail address.
  15. Preferred phone*
    Enter your preferred phone number.
    xxx-xxx-xxxx
  16. This is my:*
    Select type of phone.
  17. Alternate phone
    Enter your alternate phone number.
    xxx-xxx-xxxx
  18. This is my:
    Select type of phone.

  19. Emergency contact

  20. If you are under 18, please list your parent or guardian as your emergency contact.
  21. Name*
    Enter the name of your emergency contact.
  22. Relationship*
    Enter your relationship with your emergency contact.
  23. Preferred phone number*
    Enter phone number.
  24. This is a:*
    Select type of phone.
  25. Alternate phone number
    Invalid Input
  26. This is a:
    Select type of phone.
  27. Please list a second emergency contact in case your parent or guardian is unavailable.
  28. Name
    Enter the name of your emergency contact.
  29. Relationship
    Enter your relationship with your emergency contact.
  30. Phone number
    Enter phone number.
  31. Alternate phone number
    Invalid Input

  32. Employment

  33. Are you currently employed?*
    Indicate current student status.
  34. Current employer
    Enter your current or most recent employer.

  35. Education

  36. Are you currently a student?*
    Indicate if you are a student.
  37. School currently attending*
    Enter the school you are currently attending.
  38. Graduation date (actual or anticipated)*
    Enter your graduation date.
  39. Most recent school attended
    Enter the school you last attended.

  40. Volunteer information

  41. Why are you interested in volunteering for us?*

    Why are you interested?

  42. How did you learn of our volunteer program?*

    Enter question answer.

  43. Please list any prior volunteer experience.*

    Enter prior experience.

  44. What types of things do you like to do in your leisure time?*

    Enter leisure activities.

  45. Please list school, church, or community activities and/or clubs you belong to:*

    Enter your activities.


  48. Type of volunteer work preferred:*



    Choose a type of work.

  50. Type of volunteer work preferred:*













    Choose the type of work.
  51. Type of volunteer work preferred:*











    Choose a type of work.
  52. Type of volunteer work preferred:*








    Choose the type of work.

  54. Please list any health precautions/restrictions such as lifting, pushing wheelchairs, etc.

  55. Availability

  56. Volunteers typically donate one four-hour shift per week, scheduled according to department need and volunteer availability. Volunteers are asked to make a minimum commitment of one shift per week for six months.

  57. Which session(s) are you applying for?*


    Indicate when you want to volunteer.

  58. Availability
      Sun. Mon. Tue. Wed. Thu. Fri. Sat.
    Morning
    Afternoon
    Evening
    Select your preferred volunteer times.

  59. Availability during the school year
      Sun. Mon. Tue. Wed. Thu. Fri. Sat.
    Morning          
    Afternoon
    Evening
    After school    
    Select your preferred volunteer times.

  61. Which, if any, months are you unavailable?


  63. Confidentiality statement

  64. I recognize that as a volunteer, I will come to know confidential information found in a hospital setting. I will not disclose or discuss such privileged information with anyone. I will not reveal names of patients nor visit a patient I know, unless that information has come to me outside of hospital records. Any specific patient and physical medical information will not be discussed during breaks, lunch or in any public area of the hospital or outside of the hospital. I understand that any breach of confidentiality will result in termination of my volunteer position.

    I give my permission for HealthEast to complete a State of Minnesota background study form.


    I have read and understood the statement above. Selecting "yes" below indicates my agreement as well as my permission for HealthEast to complete the background study.

  65. Invalid Input
  66. HealthEast Volunteer Services is not obligated to provide placement, nor are you obligated to accept the position offered.

  67. Completing your application

  68. Please note, once you have submitted this form, you will be taken to a page with a health form and a recommendation form that are both required for your application to be complete.

    Your application will not be considered until these supplemental materials are returned to HealthEast.


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