• Volunteer Application

    Volunteer Application

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  • You are required to complete the Aged Care Statutory Declaration.  When you submit the Volunteer Application, you will receive an email with the Aged Care Statutory Declaration attached.  You will need to print this and have your signature witnessed by an authorised Statutory Declaration Witness ie pharmacist, registered nurse, police office etc).

  • Next of Kin/Emergency Contact

  • References

  • Please list two referees who have known you for more than 2 years and is not a family member.

  • Confidentiality Agreement

  • As a volunteer, you may come into contact with information that MUST be kept confidential.  Please read through the following statement and sign the agreement.

  • Confidential information is usually not available or readily accessible to the public. This includes all information about:

    • residents including personal and health information (PHI—which includes medical and financial information)
    • residents’ families/representatives
    • employees
    • volunteers
    • financial and operating data and proprietary information of the organisation including intellectual property and
    • any other information of a private or sensitive nature.
       

    Confidential information should not be read or discussed by any employee, student, contractor, volunteer or Board member unless pertaining to his or her specific employment/role requirements.

     

    Examples of inappropriate disclosures include:

    • Discussing or revealing personal and/or health information or other confidential information to friends or family members
    • Discussing or revealing personal and/or health information or other confidential information to other employees or volunteers without a legitimate need to know
    • Discussing personal and/or health information or other confidential information where it can be heard by people other than employees/volunteers who need to know this information
    • Discussing or revealing information pertaining to staff records (including contractors or volunteers)
    • The disclosure of employee’s and volunteer's personal information to a third party without their consent
    • The disclosure of a resident’s presence in the service, hospital, or other medical facility, without the resident’s consent, to an unauthorised party without a legitimate need to know, and that may indicate the nature of the illness and jeopardise confidentiality
       

    Careless handling of, or unauthorised disclosure of personal and/or health information or other confidential information by employees, volunteers or those with other roles with Woorayl Lodge Inc, can subject each individual and Woorayl Lodge to civil and criminal liability. Disclosure of personal and/or health information or other confidential information to unauthorised persons, unauthorised access to, misuse, theft, destruction, alteration, or sabotage of such information, is grounds for immediate disciplinary action up to and including termination.

    Confidential information may be released in any of the following circumstances:

    • where the organisation consents in writing to the disclosure;
    • where the confidential information has entered the public domain other than as a result of a breach of this statement;
    • for the purposes of complying with the requirements of any regulatory authority;
    • where release of the confidential information is required by law or pursuant to an order of a Court or Tribunal;
    • for the purpose of obtaining legal and other professional advice where such advisors are bound by obligations of confidentiality;
    • to Parliament (including committees of it), and Ministers of the Crown.

     

    Confidentiality Agreement
    I hereby acknowledge, by my signature below, that I understand that the personal health information, other confidential information, records, and data to which I have knowledge and access in the course of my employment/role with Woorayl Lodge Inc is to be kept confidential, and this confidentiality is a condition of my employment/role. This information shall not be disclosed to anyone under any circumstances, except to the extent necessary to fulfill my employment/role requirements. I understand that my duty to maintain confidentiality continues even after I am no longer employed or have a role with Woorayl Lodge Inc.

     

    I am familiar with the guidelines in place at Woorayl Lodge Inc pertaining to the use and disclosure of personal health information or other confidential or proprietary information. Approval should first be obtained before any disclosure of such information not addressed in the guidelines and policies and procedures of Woorayl Lodge Inc is made. I understand the unauthorised disclosure of such information of Woorayl Lodge Inc is grounds for disciplinary action, up to and including immediate dismissal.

  • This is to certify that I,         , a volunteer of Woorayl Lodge Inc understand that any information (written, verbal or other form) obtained during the performance of my duties must remain confidential.   

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  • Declaration

  • I,         , hereby declare that all the above information that I have provided is true and correct to the best of my knowledge.   

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