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

Gail McGillis

Receptions for Retiring CEO

Hospice Care Plus will host two retirement receptions for Gail McGillis, who announced earlier this year that she will retire at the end of 2019 after 26 years of service. Both receptions are open to the public and will include refreshments. “Gail always shies away from recognition and did not plan to hold any public…

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National Hospice Month

In honor of National Hospice Booth, Hospice Care Plus is hosting multiple information booths in Estill, Jackson, Lee, Madison, Owsley, and Rockcastle counties. The booths will feature helpful resources on advance care planning and related documents, hospice care, palliative care, family caregiver workshops, and more. Tiffani Wright, Community Liaison at Hospice Care Plus, will be…

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Celebrate NYE with the Roaring 20s

Madison Countians have a new option for ringing in the new year. On December 31, Churchill’s in Berea will host the first-ever Roaring 20s New Year’s Eve party. The event begins at 9 p.m. in Churchill’s beautiful event space and continues through 12:30 a.m. on New Year’s Day. Tickets are $75 each and are available…

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Local Family Inspires Veteran Memorial

On Veterans Day 2019, Hospice Care Plus will dedicate a Veterans Memorial Wall at our Compassionate Care Center. The dedication will take place Monday, November 11, at 1:30 p.m. at the Hospice Care Plus Compassionate Care Center. The public is invited to attend. The Veterans Memorial Wall was inspired by Richmond’s Bagby family. After their…

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Volunteer Application