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Volunteer Application

* Denotes required fields
* Gender


* When are you available to volunteer? (check all that apply)
* Are you retired?
* Are you a current high school student?
* Are you a current college student?
* Are you looking to satisfy community service hours through volunteering?
Are you currently employed?

Please list one person that can speak to your current abilities, skills and talents for volunteering (not a relative).

Emergency Contact

* Have you ever been convicted of a crime in this state or any other state, other than a minor traffic violation?
* Why are you interested in volunteering at Palos Health? (check all that apply)

Disclaimer and Signature

I affirm that the information provided in this application is true and complete to the best of my knowledge. I understand that volunteer applicants over the age of 18 will undergo a criminal background check. I consent to take the pre-volunteer physical health screening, and any such future screening(s) as may be required by Palos Health. I agree to follow hospital policies and procedures for volunteers as outlined at the volunteer orientation. I understand that volunteers are not covered by Worker’s Compensation and that I am responsible for maintaining my own health insurance. I voluntarily offer my services with a clear understanding that there will be no monetary compensation and that volunteering does not lead to employment.

I understand and agree that submitting this application form does not automatically register me as a Palos Health volunteer and that there may be certain qualifications I must meet including the acceptance of established volunteer policies and procedures before I begin volunteering.


Parent signature required if minor