Verdugo Hospice Care Center  volunteers are the heart of Hospice and among its most valuable resources. They can bring companionship to people who are on our program and respite and support to the caregiver and other family members. Volunteers are drawn from every age group and background. All Hospice Volunteers are committed to making a difference in the lives of their neighbors.
If you are interested in becoming a volunteer at Verdugo Hospice Care Center please fill out the below application and submit.

 

 

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Volunteer Application Form

General Information

(*) required fields

First Name*
Last Name*
Date of Birth
Address*
City*
State*
Zip Code*
Email address*
Home Phone
Work Phone
Cell phone
Can you receive call at works?
 YES NO Emergency Only

Perosnal References (Excluding Family Members)

First Name*
Last Name*
Phone*
Address
State
City
Zip Code
First Name*
Last Name*
Phone*
Address
State
City
Zip Code
Do you have access to Transportation?
 YES NO
Do you speak A language other than English?
 YES NO
Languages
Why DO you want to be a Hospice Volunteer?
What Qualities (Skills, Talents, Knowledge and Experience) do you fill can incorporate into your volunteer work?

Code of Ethics for Volunteer

As a volunteer, I realize that I am subject to a code of ethics similar to that which binds the professional in the field in which I work. I, like them, assume certain responsibilities and expect to account for what I do in terms of what is expected of me. I understand that any information that is disclosed to me while assisting the Hospice is confidential. I interpret "volunteer" to mean that I have agreed to work without compensation in money. Having been accepted as a volunteer worker, I expect to do my work according to the standards set forth in the Volunteer Policies and Procedures.

Declaration

I hereby certify that the statement made on this application are true and correct to the best of my knowledge. I understand that, by submitting this application I authorize inquiries to me made concerning my employment, character and public records for the purpose of determining my suitability as a volunteer. I affirm that I have read the volunteer Code of Ethics and agree to abide by its regulation. I agree to respect the confidentiality of any client information I acquire in the course of my volunteer activities with Verdugo Hospice.

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