Adult Volunteer Application

  • This application is for interested individuals who are over the age of 18 and commit to at least one year of service and over 100 hours of volunteer work.
  • UConn Health does not provide court-ordered community service opportunities.
  • UConn Health is an Affirmative Action / equal opportunity employer committed to providing equal opportunity to all applicants for all positions without regard to race, color, religion, gender, national origin, age, disability, veteran status or any other status protected under local, state or federal laws.
  • Please be aware that UConn requires volunteers to be vaccinated for Influenza annually. Volunteers who do not wish to be vaccinated can go on a leave of absence during the flu season. Please know that the season varies and can be as much as a six month period.
  • A comprehensive background check will be completed for all volunteer applicants with your signed authorization.
Personal Information
Contact Information
Emergency Contact
Availability
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Additional Information
Race
Agreement
  1. I am giving consent to having my application be visible to UConn Health Staff to determine eligibility and to having information enclosed in this application to be shared internally within UConn Health.
  2. I confirm that I have provided complete and accurate information in this application.   
  3. I authorize UConn Health to take my photograph in relation to my volunteer position.   
  4. For the safety of patients, their families, and hospital staff, the screening process for volunteer applicants over the age of 18 includes a comprehensive background check to be conducted with your signed authorization
  5. I am available for one year and will volunteer at least 100 hours.  
  6. I will hold as absolutely confidential all information that I may obtain directly or indirectly concerning patients or personnel and not seek to obtain confidential information from a patient.  
  7. I understand that I may be dismissed from my duties if I fail to comply with hospital policies and procedures, willful wrongdoing or negligence and/or performing duties outside of my service guidelines, inappropriate behavior, or any other circumstances deemed contrary by the department of Volunteer Services to the best interests of the hospital.
  8. I understand that I am expected to inform the Department of Volunteer Services of any significant change in my health status that would negatively impact on my ability to perform the tasks to which I am assigned.  
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