1. I shall keep confidential all information that I obtain regarding patients, staff, and volunteers.
2. I shall be punctual and conscientious, conduct myself with dignity, courtesy, and consideration of others, and strive to maintain professional quality in my work.
3. I shall at all times uphold the philosophy and standards of the Jean B Purvis Community Health Center (CHC)
4. I understand that CHC reserves the right to terminate my volunteer status as a result of:
a) Failure to comply with clinic policies, rules, and regulations.
b) Unsatisfactory attitude, work, or appearance.
c) Frequent, unexplained absences
d) Any other circumstance(s), which in the judgment of CHC would make my continued service as a volunteer contrary to the best interests of CHC.
All Volunteers: Must provide photo ID and clearances: PSP Criminal History Certification and PA Child Abuse History Certification
Clinical Volunteers: Must include a copy of your Pennsylvania clinical license(s) and/or certification(s) I grant CHC authorization to contact the employer or licensing bureau listed on this application for the purpose of verifying my professional license(s) and/or credentials.
The Jean B Purvis Community Health Center (CHC) does not discriminate against any person because of age, ancestry, color, disability or handicap, national origin, race, religious creed, sex, sexual orientation, or veteran status. It is the policy of CHC to select, develop, and utilize volunteers based on the individual's ability, qualifications, experience, and job performance. CHC will maintain a work environment free of all forms of discrimination, sexual harassment, and intimidation. CHC will comply with the letter and spirit of applicable local, state, and federal statutes regarding Equal Opportunity.
I have read, understand, and agree to the above Volunteer Agreement. I certify that the information I have given is complete, true, and correct to the best of my knowledge and belief. I further affirm that I have not knowingly withheld any facts or circumstances in completing this application.