What to Expect as a New Volunteer? Thank you for your interest in volunteering at Florida Hospital Heartland Division! Our volunteers serve in various departments throughout the hospital and at several off-site facilities. We make every effort to match your talents and interests with the hospitals needs. Before you begin volunteering with us, we ask that you complete the following requirements: Complete the Volunteer Application including the Background Check Authorization Form Return application to the Volunteer Services office. You will receive a letter of invitation to the next general orientation upon clearance from Volunteer Manager. General Orientation All volunteers must attend a General Orientation session regarding volunteer policies, work hours, jobs availability, by-laws, mission, benefits, and the rules and regulations of the hospital. Receive a tour of the hospital and lunch in our cafeteria. Attend a One-on-One Interview following the General Orientation. TB Skin Test All new volunteers are required to have a TB skin test. This is a free test and offered at Occupational Medicine office. Flu Vaccine Is required of volunteer during flu season Photo ID All new volunteers must have a photo identification badge. This is handled at the Human Resources office (phone 863-386-6460). A photo will be taken and a badge made. Your Photo ID can only be obtained after you are cleared of your TB skin test. Uniforms Uniforms are available in the Volunteer Office and priced at $17.00 each (this includes the cost of the uniform plus sales tax). We offer several styles available to choose from (phone 863-402-3368). Training Work at least one shift of on-the-job training with an experienced volunteer in your assigned service area.. Please detach this sheet and keep for your information. Thank you.
Volunteer Application Sebring Lake Placid Wauchula Today s Date: Please print legibly Name: Nickname: Mailing Address: City: State Zip: Home Phone: Alternate/Cell Phone: Social Security No: / / (needed in order to get an ID Badge) Birth Date Spouse Name: E-mail Address: SEASONAL RESIDENTS: What months are you here in Florida? Off Season Address: City: State: Zip: Off Season Phone #: Occupation ( Current Previous): Please indicate what skills you have: Clerical Skills: Typing Filing Phone Receptionist Copier Computer Cash Register Other: specify: Communication Skills: Public speaking Journalism Foreign language Other: specify: Patient Cares Services: (as applicable to the organization) Infant/Childcare Escort Service Read to patients Visiting / listening Other: specify: Personal Skills to Use or Teach: Painting Photography Music, Play instrument Knitting, Crocheting or Sewing Baking Other: specify: Additional skills/comments: List other organizational volunteer activities you have been involved with: Would you be willing to work closely with patients? Yes No Who recommended the Volunteer Program to you? Phone 1
Highest level of education? High School/GED Associates Degree Bachelor s Degree Graduate s Degree Have you ever pled guilty to any criminal offense (misdemeanor or felony) other than parking tickets? Yes No Have you ever pled nolo contrendre (no contest) to any criminal offense (misdemeanor or felony) other than parking tickets? Yes No Have you ever been convicted of any criminal offense (misdemeanor or felony) other than parking tickets? Yes No If you answered yes to any of the last three questions, please provide information on all criminal offenses, dates, locations- city, county, state- and disposition of case. IF ANY OTHER TYPE OF ALTERNATIVE, DEFERRED, SUSPENDED, POSPONED, OR CONDITIONAL PROSECUTION, ADJUDICATION, DISPOSITION, SENTENCE, PROGRAM OR RELEASE, PLEASE DESCRIBE. Please provide us with one reference (an individual you have known for at least two years not relatives): Name Phone Email Address Name and Phone of Person to Notify in case of Emergency: Name: Relationship: Phone: Alt Phone: What areas are you interested in volunteering at Florida Hospital? (Please list in order by area name): (1) (2) (3) (4) (5) (6) Assignments will be matched to availability on the shift they are needed. What days are you available: What Time: (Shift hours may change for different departments) S M T W Th F S 8-12 12-4 4-8 Are there any physical limitations we should be aware of: If you have any further questions, please call the Volunteer Coordinator at 402-3368. THANK YOU for your interest in serving as a volunteer. Signature: Date: 2
Florida Hospital Heartland Division Rules of Conduct for Student Volunteers 2016 To maintain the Student Volunteer standards of FHHD and its Auxiliary, the student volunteer must be closely supervised, and the quality of work must be high. For this reason, the following rules must be observed: 1. Student Volunteers must never discuss a patient s information with anyone else not directly involved with the patient s care. 2. A student volunteer must be well groomed, with clean uniform and proper shoes. (Please see uniform guidelines in orientation folder.) 3. A student volunteer should be courteous and willing to serve at all times. 4. Fraternization with hospital personnel is strictly forbidden. 5. Student volunteers are not permitted to leave hospital area during their scheduled shift. 6. No loitering is permitted on the hospital grounds after completion of service. If it is necessary to wait for transportation, this must be done in the main lobby. 7. Please do not chew gum while on duty. 8. Congregating in groups while volunteering is NOT permitted. 9. Please check with Service Area Chairman, Volunteer Coordinator, or Director of Volunteers if student desires to have extra unscheduled service hours. 10. Smoking is not permitted anywhere on campus or hospital property and is subject to dismissal. 11. Student volunteers may not use the telephone for personal phone calls or cell phones for texting. They are permitted use of the telephones for emergency calls only and cell phones should be turned off during service hours. Please do not carry your cell phone while volunteering. 12. Notification must be given to the Volunteer Office- 402-3368 as much in advance as possible if the student cannot work their scheduled shift. GENERAL INFORMATION: 1. In case of injury, or if you should become ill while on duty, you are to report immediately to your Service Area Chairman, Volunteer Coordinator, Director of Volunteers or manager in charge of your volunteer area. 2. Do not ask for special privileges or medical advice for yourself or for others. 3. Neither the Auxiliary nor the hospital is responsible for the student volunteer before or after assigned hours of service. EXPECTATIONS- A Student volunteer is expected to be: Gracious Respectful & Courteous Friendly, but not familiar Pleasant Quiet Efficient Prompt Strictly confidential As the parent of this student,, I have read and understand these guidelines and will support my child in meeting this commitment. Parent/Guardian signature: Relationship to student: Date: Student signature: I have read and understand these guidelines and the commitment I am making. Please return to Volunteer Coordinator at orientation to be kept in student s file.
PARENT/GUARDIAN CONSENT FORM FOR PARTICIPATION IN STUDENT VOLUNTEER PROGRAM I hereby state that my Son/Daughter is years old. I give my consent for my Son/Daughter to serve as a volunteer in the Student Volunteer Program at Florida Hospital Heartland Division. I will read the Rules of Conduct concerning the Student Volunteer Program and discuss them with my Son/Daughter. I understand that each member is required to contribute one 4-hour shift per week and will support my child in this regard. The days/hours indicated on the application are permissible for my Son/Daughter to work. Yes No Transportation to and from the hospital is assured? Yes No My Son/Daughter s general health is: Good Fair Poor Are there any health limitations? Yes No If so, please specify: Are there any vacations planned that will interfere with volunteering during the summer months? If so, please specify: I hereby give authorization to Florida Hospital to evaluate my Son/Daughter: this will include, but may not be limited to the pre-placement exam, PPD skin test, or chest x-ray. I understand that I may also have the TB skin test done by any physician of my choice, at my expense, and then furnish proof of testing to the Volunteer Office. I hereby give authorization to Florida Hospital to administer the influenza vaccine during influenza season. I understand that I may also have the influenza vaccine done by any physician of my choice, at my expense, and then furnish proof of the vaccine to the Volunteer Office. I hereby give authorization to Florida Hospital to evaluate and treat my Son/Daughter should my Son/Daughter be injured on the job. This may include physical examination, lab work, chest x-ray etc. I understand that depending on the reason for the treatment authorized in this document, I may be responsible for the associated expenses. I hereby give permission to Florida Hospital for my Son/Daughter to have a photo ID and will provide their Social Security number for obtaining a photo ID. I understand that the photo ID is required by FHHD for volunteer services at their facilities. Student Signature: Date Parent /Guardian Signature Relationship to Student Address Home Phone Work Cell