Thank you for your interest in volunteering. However, the minimum age for volunteering is 16. Please consider applying again in the future.
Volunteers average between 4-8 hours per week. Working together, we'll try and find a regular (weekly) day and time for your volunteer activities. Below, mark the days and times that you would be available for a weekly commitment.
If your availability will change soon, please make note of the effective date of the change in the additional information.
Pursuant to the requirements of RCW 43.43.830.840, we must ask you to complete the following disclosure statement. This information will be kept confidential.
We may request your fingerprints to obtain from the Washington State Patrol criminal identification system a report of your record of criminal convictions for offenses against persons, civil adjudications of child abuse, and disciplinary board final decisions. If you are placed before that report is available, YOUR SERVICE WILL BE CONDITIONED UPON THE RECEIPT OF A SATISFACTORY REPORT.
You will be notified of the State Patrol's response within ten days after we receive the report. We will make a copy of the report available to you upon your request.
My services are donated to the hospital without contemplation of compensation/remuneration, benefits, or future employment from Skagit Regional Health, and given with humanitarian reasons.
I understand that I must provide proof of flu vaccination during declared periods of flu activity. Flu vaccination must occur a minimum of 2 weeks prior to volunteering. If I decline, I may be required to mask while on duty or take other appropriate protective measures.
I understand that volunteers are asked to complete a minimum of 100 hours before requesting recommendations or receiving credit for hours volunteered. As the number of positions is limited, prospective volunteers should apply at least a year in advance of any school deadlines that may be applicable. High school students seeking course or club credit should apply and begin volunteering before their senior year.
I understand that it is the policy of Skagit Regional Health ("SRH") to respect the right of confidentiality for all of our patients and employees and to insist that all volunteers with access to patient confidential information and Protected Health Information at SRH strictly maintain the confidentiality and integrity of this information. "Confidential Information" includes all facts relating to the patient's medical care (past, present or future), including oral information, written information, and any computerized records or data. "Confidential Information" also includes patient financial information, employee records (medical or otherwise) and any other information of a private or sensitive nature at SRH, including financial and operating information of SRH. I agree to strictly adhere to this confidentiality statement.
I hereby certify that there are no willful misrepresentations or falsifications of any of the statements or answers to questions on this application.
Parental Consent (Teens 16 through 17)
Your signature indicates your approval for your child's participation in the volunteer program at Skagit Regional Health. You also acknowledge that Skagit Regional health is not liable for any accidents or injury incurred by the student while engaged in the voluntary service.
I hereby grant permission for my child (named below) to be given a flu vaccination and to be screened for the presence of Tuberculosis ("TB") by means of a skin test (referred to as a Mantoux test I understand that if my child has never been tested for TB in the past, a second test will need to be administered within one month of the first test. If the test should produce a positive result I give my permission for a chest x-ray (at no charge) and understand that follow up will be required by the child's physician and/or the Skagit County Health Department. I give my permission for any necessary treatment to be given in the event of illness or injury. I understand that all volunteers will be required to provide proof of immunity to Measles, Mumps and Rubella. A valid vaccination record showing two MMR vaccinations or blood work that shows immunity evidences proof.
In the event of my child's illness, injury or emergency, please contact: