Volunteer Application

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Phone *

Email *

Date of Birth *

Format: MM/DD/YYYY

Are you 18 years of age or older? *

Yes

All prospective volunteers who are 18 years of age or older is required to complete a background check. Click here to download the form.

Facility where you want to volunteer *

Areas of Interest (check all that apply)

Inpatient Units

Main Information Desk

Critical Care Unit

Surgery Center

Neonatal Intensive Care Unit

Foundation Office

Foundation Events

Preferred Days and Times (check all that apply)

Days

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Times

Mornings (7am-11am)

Afternoons (1-5pm)

Duration

1-5 months

Summer (Seasonal)

Long term

Please share why you would like to volunteer at Baptist Health *

Photograph & News Consent

(“Photographic Materials”) of the above named patient and to use his or her name in connection with any such Photographic Materials: The undersigned hereby permits BAPTIST HEALTH and its agents to use and distribute such Photographic Materials together with the name of the above named patient as often as desired for any lawful purpose, in accordance with applicable law. I hereby waive all rights of prior inspection or approval and release BAPTIST HEALTH and its agents from any and all claims or demands that may exist on account of the lawful use, disclosure or publication of such photographic materials as described herein.

I grant BAPTIST HEALTH permission to take photographs, motion pictures and/or videotapes *

COVID-19 Risk Acceptance and waiver

In choosing to engage in any of these or other volunteer opportunities that may become available, you are also agreeing again to abide by all Baptist Health policies and to conduct yourself in a professional manner. You understand that these activities may increase your risk of exposure to COVID-19 and other illnesses or injuries. COVID-19 is a pandemic virus which could cause you to become ill to the point of permanent harm or death. You accept that risk and understand that the risk of transmission of COVID-19 is high and that it appears to spread through the community easily, potentially putting you and those you come in contact with at risk. You additionally understand that contact with a known or suspected COVID-19 patient could require that you enter quarantine for at least fourteen (14) days. You further agree to maintain patient confidentiality and comply with all HIPAA and patient privacy rules. Certain risks are inherent to and associated with the various activities, research, and patient care conducted at Baptist Health.

By choosing to volunteer in these activities:

You are agreeing to assume all of those risks and to hold harmless Baptist Health and the Board of Trustees of Baptist Health and Foundation, their agents, officers, and employees and to not hold them responsible or liable for any harm or injury, from any cause, relating to or arising from these activities.
You are agreeing to indemnify and hold harmless the same entities and persons from the claims of other persons arising out of your acts or omissions.
Also, you understand that any criminal act or intentional tort committed by another person against you is against Baptist Health policy and outside the scope of that person’s employment or relationship with Baptist Health, and that Baptist Health is not vicariously liable for such acts.
Finally, you understand that these conditions and agreements are binding on all of your heirs, executors, administrators, representatives, assignees, successors, and estates.

I acknowledge that I have read and understand everything above *

Vaccination Requirements

I understand that I will be required to provide proof of my Flu and COVID-19 Vaccinations *