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 grief care program is 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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Shadow Box Workshop July 12

A special workshop to help individuals and families remember and honor a loved one is coming July 12. The Shadow Box Workshop gives participants all the supplies they need—shadow boxes, scrapbook materials, and creative tools—to make their own shadow box or scrapbook page to display at home. There is no fee. All are invited, though…

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Success!

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Hospice Hoedown Coming Apr. 12

A hoedown is coming to Mt. Vernon, and it’s for a great cause. The first-ever Hospice Hoedown is Friday, April 12 at 7 p.m. at the Silver Eagle. Touted as old-fashioned fun, organizers say the Hoedown will feature live music by Strait Shot, a homemade BBQ meal, a cake walk, cloggers, dancing, a silent auction,…

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Medicare 101 for Family Caregivers

U-Care is hosting Medicare 101 for Family Caregivers on April 12, 1:00 to 4:00 p.m. at the Appalachian College Association in Richmond (801 Brighton Ave., Richmond, next to Galaxy Bowling). Registration is required and is free for all family caregivers. The workshop is ideal for those caring for a family member on a part-time or…

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Volunteer Application