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Hospice Volunteer

Hospice Volunteer Application

About You
First Name *
Last Name *
Country
Address Line 1 *
City *
State/Province *
Postal Code *
Month
/
Day
/
Year
Emergency Contact
First Name *
Last Name *
Volunteering with Tabitha Hospice
Why would you like to volunteer with Tabitha Hospice?
More About You
Have you served in the military?
Military Branch
Service Dates
Availability
What days are you available to volunteer? (check all that apply)
What time of day are you available to volunteer? (check all that apply)
Transportation

Volunteers who use their personal vehicles to visit clients or run errands for Clients or family members do so under their personal automobile liability coverage.

Do you have access to transportation?
Driver's License:
State
License Number
Auto Insurance:
Agent/Phone:
To ensure the safety of our clients, Tabitha conducts background checks.
Have you ever been convicted of a crime, other than minor traffic violations?
References (please list two adults who are not family members):
First Name *
Last Name *
First Name *
Last Name *

By clicking SEND, I agree that:

As a volunteer, I realize that I am subject to a code of ethics similar to that which binds the professionals in the field in which I work.  I, like them, assume certain responsibility 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 volunteering in the Tabitha Hospice Program is confidential and must be shredded.

I hereby authorize the release of information regarding my abilities. I further release all persons and Tabitha from any and all liability resulting from the furnishing of such information. All information listed by me on this application is true and correct to the best of my knowledge. 

Finally, I interpret "volunteer" to mean that I have agreed to work without compensation in money. Having been accepted as a volunteer, I will follow the policies and procedures presented during the volunteer orientation, as directed by the Hospice Volunteer Coordinator, and according to the standards set forth in the Volunteer Policies and Procedures.

 
Resources

Want to learn more about Tabitha’s renowned, compassionate hospice care? Contact a Tabitha Senior Care Expert today or call 402.486.8506 for more information. We’ll connect you with the Tabitha resources that best fit your own or your loved one’s aging journey.
 

ABOUT HOSPICE  |  WHY TABITHA HOSPICE  |  GETTING HOSPICE CARE  |  HOSPICE TEAM  |  HOSPICE MEDICAL DIRECTORS  |  VETERAN SERVICES  |  HOSPICE STORIES  |  CAREGIVER RESOURCES  |  VOLUNTEER  

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