Bon Secours - Greenville Volunteer Application

Adult Volunteer

Thank you for your interest in volunteering with Bon Secours! Volunteers in the St. Francis Health System are highly valued members of our team. Our volunteers provide support to our staff, patients and their families each year.

In return, we offer a variety of places and ways to serve, opportunities to match your interests and talents to meet the needs of those we serve, valuable learning opportunities and programs that integrate volunteers into Bon Secours St. Francis Health System's quality patient care mission.

Volunteer requirements include being able to maintain a minimum of four hours of service per month, completing the volunteer application below, an interview with the Volunteer Services Coordinator, attending a health system orientation, completing a health assessment (including lab work and a minor physical) and completing a personal background check.

Please complete the information below and our Volunteer Coordinator will be in touch with you shortly. For more information, contact Susie Jeter, Volunteer Coordinator, at 864-255-1234.

Note that volunteer opportunities vary by location.

Hospice Volunteer

Thank you for your interest in the Open Arms Hospice Volunteer Program! Please note that applicants who are recently bereaved or who have family currently in hospice may be asked to wait at at least a year to apply.

Volunteer requirements include being 15 years old by June 1 (for teen program), being able to maintain a minimum of four hours of service per month, completing the volunteer application below, an interview with the Volunteer Services Coordinator, attending a health system orientation, completing a health assessment (including lab work and a minor physical) and completing a personal background check.

Please complete the application below and our Volunteer Coordinator will be in touch with you shortly. For more information, contact Susie Jeter, Volunteer Coordinator, at 864-255-1234.

Note that volunteer opportunities vary by location.

Student Volunteer

Students are our future in this rewarding field and we need you. We have various summer volunteer opportunities for high school and college students providing them with exposure to and service with various medical professionals. The summer program runs from June 1st through mid-August.

Please complete the information below and our Volunteer Coordinator will be in touch with you shortly. For more information, contact Susie Jeter, Volunteer Coordinator, at 864-255-1234.

Note that volunteer opportunities vary by location.

Select your volunteer type

Please make sure to select the correct volunteer type.

Adult Volunteer - If you are over the age of 18 and are not currently enrolled in academic courses.

Hospice Volunteer - If you are specifically interested in volunteering at a hospice facility.

Student Volunteer - If you are currently enrolled in academic courses (i.e. high school or college-level courses).

First Name

Last Name

Phone Number

Street Address

Address Line 2

City

State

Postal / Zip Code

Current Occupation

Current School Attending

Are you 18 years or older?

Marital Status

Do you have reliable transportation?

Physical Limitations

Have you ever been convicted of a crime? If yes, please explain.

Volunteer Preferences and Questions

Location where you prefer to volunteer

Location where you prefer to volunteer.

Preferred time of day to volunteer. Please select all that apply.

MorningsAfternoonsEvenings

Do you have prior hospital experience?

YesNo

How did you hear about our program?

Please explain any other volunteer experience you have.

How much time would you like to commit to volunteering with us?

Do you want to work directly with patients and families?

Were you referred to us by a current volunteer? If yes, who?

Why do you want to volunteer with us?

What do you believe is a strong attribute of your personality? What is a your weakness?

Because of the nature of working with those who are terminally ill, when and who was your last experience with death? Will you be able to handle working directly with patients?

Would you be able to volunteer with anyone (patients or other volunteers) who have different religious views than you? Please explain in detail.

What if any, bias do you have about race, age, gender or persons infected with HIV or AIDS?

What do you hope to gain most from your volunteer experience?

Hobbies/Skills/Interests

Volunteer Emergency Information

Emergency Contact Name

First

Last Name

Last

Emergency Contact Phone Number

Allergies

In the event of a medical emergency, medical information we should know?

References

Personal Reference #1 Name (other than family)

Personal Reference #1 Phone Number

Personal Reference #2 Name (other than family)

Personal Reference #2 Phone Number

I certify that answers given here are true and complete to the best of my knowledge. I hereby give St. Francis permission to contact the listed references, physician, and to conduct a drug screening or criminal check if appropriate. A health assessment and safety training are required by the hospital. I understand that volunteer placement is contingent upon completing all initial and future health requirements and training as required by Bon Secours St. Francis Health System. I agree with the above statements.

Click if you agree to the statement above.

I authorize St. Francis Hospice to make inquiries of my personal/volunteer history, and to request a medical clearance form be completed by my physician or WorkWell department (St. Francis Employee Health). I hereby release employers, schools, or persons from all liability in responding to inquiries in connection with this application. I also authorize St. Francis Hospital Hospice to conduct a background check on me according to the Pre-Employment Background Checks policy. I understand that my volunteer work may not begin until satisfactory background information has been received. I also understand that St. Francis Hospital System will assume all costs of this background research. I understand that confidentiality must be maintained by every hospital employee and volunteer. Under no circumstances may information concerning patients and their families be repeated to anyone except those authorized to receive such information. I agree to abide by the policies and procedures of Open Arms Hospice. I understand that a hospice volunteer training and on-site orientation is required and must be completed before I volunteer. I agree with the above statements.

Click if you agree to the statement above.

Parental Consent

I hereby permit my child to participate in the Student Volunteer Program at Bon Secours St. Francis Health System. I give St. Francis permission to contact the listed references and release St. Francis from any liability as a result of such contact. I understand the responsibilities of being a volunteer and the commitment required.

Check if you agree to the statement above.

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