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 Name
Middle Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Current Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Phone Number
Emergency Contact Name, Relationship and Phone Number
How did you hear about us
Please Select
LinkedIn
Event
Social Media
HHHS Website
Family / Friend
Another Volunteer
Flyer/Poster
Local Media
Radio
Newspaper
Other
Available Start Date
/
Month
/
Day
Year
Background information
Computer Skills
CPR/First Aid Certificate
Drivers License
Safe Food Handler Training
Sign Language
Crisis Aversion and Response
Gentle Persuasive Approach
Please list any relevant work, volunteer and experience.
Languages Spoken
English
French
Other
Availability
Season Preferred (select all that apply)
Winter
Spring
Summer
Fall
Days Preferred (select all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Time (select all that apply)
Morning
Afternoon
Evening
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 Program
Meals On Wheels
Social Recreation & Wellness Programs
Diners Club
Transportation (volunteer driver)
Friendly Visiting/Security Check Calls
Hospice
Hospital Welcome Station
Pastoral Care
Gift Shop
Long Term Care
IT (technical support)
Physiotherapy
Community Ambassadors
Home Help Home Maintenance/ Brokered Worker
Hospital Visiting
Office Assistance
Indirect client, resident and patient volunteering- (these roles do not require a health review) Check all that apply
Entertainer
Musician
Gardeners
Event Helpers
Pet Therapy
Committees
Board
Minden Auxiliary
What areas would interest you to participate as a committee member or document/policy reviewer (check all that apply)
Ethics
Emergency
Diagnostic Imaging
Diabetes
Infection, Prevention & Control
Laboratory
Long Term Care
Medicine (inpatient care)
Mental Health
Pharmacy
Patient Flow
Patient Safety, Quality & Risk Management
Non-Clinical/Administration
Other
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 surveys
Developing/reviewing patient/family educational materials and website resources
Planning for the impatient experience
Planning for the outpatient experience
Planning for the emergency care experience
Ensuring patient safety and the prevention of medical errors
Education students, staff, physicians and volunteers about the experience of care and effective communication support
Improving coordination of care, discharge planning and the transition to home and community care supports
Developing the uses for information technology, including electronic medical records
Committee work specific to above interests
Other
Apply
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