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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Register Now for the Summer Fun BBQ!

The annual Summer Fun BBQ fundraiser is celebrating its 10th anniversary, and everyone is invited. Join hosts Mr. and Mrs. Verlon Prewitt on Saturday, August 13 at 6pm for “Summer Fun BBQ under the Big Top.” The event will be held at the Prewitt farm on Cedar Grove Road in Irvine. This year’s BBQ features…

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To See Blake Shelton

June 6, 2016, was a magical day for Hospice Care Plus patient, Brenda Roberts. She was in the audience to see one of her favorite people, Blake Shelton, perform at the Country Music Hall of Fame CMA Theater in Nashville.

don ray

To Give Back

Don Ray loved music. Specifically, he loved to collect it, sing it, and entertain with it. By the time he chose hospice care, he had thousands of CDs that made up an impressive collection for one of his favorite hobbies: karaoke.

1-15 Marlene plays carillon_cdw (4)

To Make a Joyful Noise

Marlene Payne had a very specific wish. Granting that wish would involve getting her up five flights of stairs into a bell tower, so she could play the instrument she loved one more time.

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Volunteer Application