Volunteer Application - Hospice Care Plus

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Care & Support
Get Involved
News & Events
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- Events

Ready To Make a Difference?

Volunteers have been at the heart of Compassionate Care Plus since 1981, and they continue to make a meaningful difference every day.

Whether you're providing companionship to patients, supporting families, assisting with special events, or lending your skills behind the scenes, there's a volunteer opportunity that's right for you. Whether you have one hour a month or ten hours a week, we'll work with you to find a role that fits your interests, talents, and schedule.

We'll provide the training, resources, and support you need to feel confident and prepared.

Take the next step by completing our volunteer application or learning more about our volunteer training program.

Volunteer Application

Downloadable Volunteer Application

Volunteer Interest Form

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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 *

First

Last

Home Phone *

Email *

Cell Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Education and Employment:

Educational Experience:

Employment Experience:

Are you currently enrolled in school? *

Are you currently employed? *

Educational Level: *

Employer:

Specify field of study/degree *

Position/Hours:

Additional training, certifications, license...

Briefly describe the type of work you do:

Please check all special skills or hobbies that apply to you: *

Foreign Language
Computer/Data Entry
Light Housekeeping
Pet Care
Arts/Crafts
Cooking/Baking
Singing/Playing Instrument
Fix-it Capabilities
Gardening/Yard Work
Event Planning
Errands
Hairstyling
Other

Foreign Language? What do you speak? How fluently? *

If other, what are your skills? *

Personal Information:

Have you done other volunteer work? If yes, briefly describe:

Why do you wish to be a volunteer?

Do you have a valid driver's license? *

Yes
No

Do you have reliable transportation? *

Yes
No

Do you have auto insurance? *

Yes
No

Programs and Placements:

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

Home Hospice Care
Compassionate Care Center
Palliative Care
Grief & Loss Support
Nursing Homes
Assisted Living Facilities
Administrative Support
Special Event Support

Areas of Interest (please check all that apply): *

Companionship
Transportation
Phone Calls
Light Housekeeping
Meal Prep
Mailings
Home Repair/Maintenance
General Office Help
Greeter
Children's Activities
Floral Arrangements
Arts/Crafts
Pet Therapy
Fundraising
Photography
Videography/Video Editing
Baking/Cooking
Veteran Recognition
Public Speaking
Comfort care for the actively dying (Vigil)

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 *

First

Last

Address *

Address Line 1

City

State

Zip Code

Phone *

Relationship *

Years Acquainted *

Reference 2:

Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Phone *

Relationship *

Years Acquainted *

Emergency Contact

Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Phone *

Relationship *

Years Acquainted (copy) *

Section Divider

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.

Signature *

Clear Signature

Date / Time

Date

Time

Isn’t it expensive?

NO. The cost of care is covered by Medicare, Medicaid, and private insurance. We also provide a free Grief & Loss Support program for anyone in the community who may need this service.

We provide care for all, even those who may be underinsured.

News & Events

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Lemetta Dause Memorial Tourn., Aug. 21

The 10th Annual Lemetta Dause Memorial Bowling Tournament is scheduled for Sunday, August 21, at 2:00 p.m. at Galaxy Bowling Center in Richmond. The tournament is organized by the Madison County Bowling Association (MCBA) in memory of Mrs. Dause, who was cared for by Hospice Care Plus. It is one of MCBA’s largest tournaments of…

Lydia Wilson

Volunteer Fair Coming June 23

Hospice Care Plus will host its first-ever Volunteer Fair on Thursday, June 23, from 12 p.m. to 2 p.m. at its Compassionate Care Center in Richmond. Mariah Smith, volunteer coordinator at Hospice Care Plus, is organizing the event to give community members a chance to explore volunteer opportunities with the organization. “A lot of people…

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…

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…

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