You have been asked to provide a reference for a volunteer applicant of Hospice Care of Southwest Michigan. Please consider the questions listed below carefully and provide any additional information you think would help us evaluate this applicant's candidacy. All information you provide will be kept strictly confidential. Thank you for your prompt attention. If you have any questions, please call 269-345-0273 and ask to be connected to the Volunteer Department.
Your Phone Number
Name of Applicant
How well do you know the applicant?
How long have you known the applicant?
What is your relationship to the applicant?
Have you had any contact with the applicant in the last 12 months?
Please rate the applicant on the following characteristics.
Do you recommend that this applicant become a volunteer for Hospice Care of Southwest Michigan?
Should be Empty: