• Health and Hope Medical Outreach

  • Health and Hope Medical Outreach - Volunteer Application

  • Health and Hope Medical Outreach Volunteer Application

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  • EMERGENCY CONTACT INFORMATION:

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  • WORK EXPERIENCE: (Begin with most current)

  • Volunteer Application Continued

  • I hereby certify that the above is true and complete to the best of my knowledge.

    By submitting this application, I authorize HHMO and its representatives to investigate and verify any and all of the information in this volunteer application, including a criminal background check, education verification, license verification and National Provider Data Base

    HHMO EOE Policy It is the policy of HHMO to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual orientation, age, or disability.

    Thank you for completing this application form and for your interest in volunteering at HHMO.

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  • Health and Hope Medical Outreach - Volunteer Agreement

  • Health and Hope Medical Outreach Volunteer Agreement

    Thank you for your interest in volunteering at HHMO. Before being placed in a volunteer position there are some important guidelines of which you need to be aware. Volunteering is a fun and rewarding experience, but it requires a commitment since patients, staff and other volunteers are relying on you.

    All volunteers are expected to honor the following statements. Please review them carefully prior to your volunteer orientation and feel free to ask any questions that you may have at that

    As a volunteer at Health and Hope Medical Outreach I agree to:

    • Report on time for my scheduled shift.
    • Notify the Executive Director at least one week in advance of any cancellations or changes to my volunteer schedule. (We understand that illness and family emergencies are unavoidable but please call the clinic as soon as you know that you cannot work a scheduled shift).
    • Comply with all HHMO policies, protocols, procedures, and objectives.  
    • Respect all HHMO staff and fellow volunteers.
    • Respect and maintain confidentiality in regard to all personal and medical information of patients at HHMO .
    • Provide health care services with courtesy and respect to all patients and their family members. 
    • Report any incidents, concerns, or disputes to the proper HHMO staff.

    Health and Hope Medical Outreach agrees to:

    • Provide orientation, training, and support to all new volunteers.
    • Respect, support, and recognize the efforts of all volunteers.

    HHMO reserves the right to terminate the relationship between itself and the volunteer if at any time service is found to be unsatisfactory or in the event that the provided services are no longer needed.

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  • Health and Hope Medical Outreach - Volunteer Confidentiality Agreement

  • Health and Hope Medical Outreach Volunteer Confidentiality Agreement

  • That all information I am exposed to regarding patients, program participants, volunteers, family members of patients/volunteers customers, and/or employees of HHMO, and their partners/collaborators may be governed or protected by federal, state and/or local regulations and, where privileged, is to be held in the strictest confidence.

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