Volunteer Application

Volunteers are vital to our mission of providing compassionate care for all, regardless of ability to pay.

They provide a special kind of caring and practical help for our patients and their families or work alongside our staff behind the scenes.

Whether it’s offering a listening ear to patients and families, providing respite care for exhausted caregivers, helping us prepare a large mailing, or sharing personal expertise, the hours our volunteers give can be the most rewarding experience of their lives.

Our volunteers come from all walks of life. Some work during the day, some are retired, and others volunteer while attending school. Whatever your life allows, we work with you to find an opportunity that fits.

While training is required, we make it as easy as possible to get started.

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Volunteer Application Form

Thank you for your interest in volunteering. This information will provide us with an understanding of your interests and abilities. Some questions may seem personal; however, the information is helpful in determining the best role for you.

General Information

Name
Address

Education and Employment:

Educational Experience:
Employment Experience:
Please check all special skills or hobbies that apply to you:

Personal Information:

Do you have a valid driver's license?
Do you have reliable transportation?
Do you have auto insurance?

Programs and Placements:

Programs/Settings of Interest (please check all that apply):
Areas of Interest (please check all that apply):

References:

Give the names of two persons not related to you, whom you have known at least one year. Sharing their information means you authorize Hospice to contact the persons listed below to obtain personal reference checks.

Reference 1:

Name
Address

Reference 2:

Name
Address

Emergency Contact

Name
Address

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Please read the following statement carefully before signing to indicate your understanding:

I certify that the facts contained in this application are true and complete to the best of my knowledge. I authorize investigation of all statements contained herein and the references listed above, and release all parties from liability for any damage that may result from furnishing same to you.

I understand as a condition of my volunteer service, I will be required to undergo screening and other pre-service requirements.

Clear Signature
Date / Time

Isn’t it expensive?

NO. The cost of care is covered by Medicare, Medicaid, and private insurance. Our palliative and grief care programs are donor supported and you are not invoiced for care.

We provide care for all, regardless of insurance status or ability to pay.

News & Events

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KHN Substance Use Disorder Inservices

The Kentucky Hospice Network (KHN) is proud to present a two-part virtual inservice: Substance Use Disorder in Hospice: Part I Thursday, May 26, from 4 PM to 5 PM EST on Zoom and Substance Use Disorder in Hospice Part II: De-Escalation and Communication Thursday, June 9, from 4 PM to 5 PM EST on Zoom…

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Hospice Wounds: Registration & CEU Info

The Kentucky Hospice Network (KHN) presents a virtual inservice: Hospice Wounds: Assessment, Management & Prevention at End of Life Thursday, April 28, from 3 PM to 4 PM EST on Zoom Registration is available online.   Continuing education units are available for nursing. Our Speaker: Toccara Jule, RN, BSN, MBA, CPHQ, CHPN, CSSGB, CWOCN Toccara…

Guests at the most recent Bourbon, Boots & BBQ Derby Eve Party.

Bourbon, Boots & BBQ Returns!

    Madison County’s longest-running Derby Eve party is back after a two-year, pandemic hiatus. The Bourbon, Boots & BBQ Derby Eve Benefit will take place Friday, May 6, at 6 p.m. at the Richardson Hall Building-Madison County Fairgrounds. Reservations are open through April 29 and are available online or by calling 859-986-1500. All proceeds…

Hearts for Hospice 2021-Web-Featured Image (1)

Give a “Heart for Hospice” in Feb.

For the entire month of February, several local banks are hosting the annual “Hearts for Hospice” fundraising event. When you visit a participating bank in the lobby or at the drive-through, you will have the opportunity to request a memorial heart for a donation of at least one dollar. Donors write their name or the…

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Volunteer Application