Volunteer Application

Volunteer Application

Please complete the form below to apply for a position with us. If you do not hear from anyone within 72 hours please contact 705-457-1392 ex 2927. Please note we do require a clear criminal reference check and possibly a vulnerable sector prior to your start. Looking to learn more about Volunteering opportunities at HHHS? Please visit https://www.hhhs.ca/volunteers for more information
Full Name*

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
Date
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Phone Number
Format: (000) 000-0000.
Emergency Contact Name, Relationship and Phone Number
How did you hear about us
Available Start Date

MonthDayYear
Background information

Computer SkillsCPR/First Aid CertificateDrivers LicenseSafe Food Handler TrainingSign LanguageCrisis Aversion and ResponseGentle Persuasive Approach
Please list any relevant work, volunteer and experience.
Languages Spoken

EnglishFrenchOther
Availability
Season Preferred (select all that apply)

WinterSpringSummerFall
Days Preferred (select all that apply)

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Time (select all that apply)

MorningAfternoonEvening
Areas of interest

Click here to see a full listing of all volunteer positions https://www.hhhs.ca/volunteers
Direct client, resident and patient volunteering- (these roles may require a health review) check all that apply

Adult Day ProgramMeals On WheelsSocial Recreation & Wellness ProgramsDiners ClubTransportation (volunteer driver)Friendly Visiting/Security Check CallsHospiceHospital Welcome StationPastoral CareGift ShopLong Term CareIT (technical support)PhysiotherapyCommunity AmbassadorsHome Help Home Maintenance/ Brokered WorkerHospital VisitingOffice Assistance
Indirect client, resident and patient volunteering- (these roles do not require a health review) Check all that apply

EntertainerMusicianGardenersEvent HelpersPet TherapyCommitteesBoardMinden AuxiliaryFoundation Support (special events or office help)
What areas would interest you to participate as a committee member or document/policy reviewer (check all that apply)

EthicsEmergencyDiagnostic ImagingDiabetesInfection, Prevention & ControlLaboratoryLong Term CareMedicine (inpatient care)Mental HealthPharmacyPatient FlowPatient Safety, Quality & Risk ManagementNon-Clinical/AdministrationOther
What would you be interested in helping with as a committee member or document/policy reviewer (check all that apply)? (check all that apply)

Reviewing patient and family satisfaction surveysDeveloping/reviewing patient/family educational materials and website resourcesPlanning for the impatient experiencePlanning for the outpatient experiencePlanning for the emergency care experienceEnsuring patient safety and the prevention of medical errorsEducation students, staff, physicians and volunteers about the experience of care and effective communication supportImproving coordination of care, discharge planning and the transition to home and community care supportsDeveloping the uses for information technology, including electronic medical recordsCommittee work specific to above interestsOther
Should be Empty:

Volunteer Application

Availability

Areas of interest