DCH Regional Medical Center
Northport Medical Center
Fayette Medical Center
Pickens County Medical Center
Centers of Excellence
Bloodless Medicine & Surgery
Lewis and Faye Manderson Cancer Center
Employee Assistance Program
Home Care Services
Robotic & Minimally Invasive Surgery
Wound Healing Center
News & Information
DCH Online Job Application
Areas of Local Interest
Human Resources Hours of Operation
Classes and Events
Find A Doctor
Health Site Links
Last 4 digits of your Social Security number
I wish to provide volunteer services for DCH Health System.
As a volunteer, I understand that I am not entitled to and will not receive any compensation, salary, benefits, or other payments in exchange for my providing volunteer services to the facility.
I understand that my volunteer service is donated without contemplation of future employment and given with humanitarian, religious, or charitable reasons.
I understand that as a volunteer, I am not covered by any state or federal wage and hour laws, nor am I eligible for workers compensation, unemployment insurance benefits, or any other benefit available to employees.
I shall not sell or attempt to sell goods or services, request contributions, or solicit persons to sign or distribute petitions on hospital premises.
I shall submit to initial examinations and annual retesting as necessary, which may include skin tests, chest x-rays, and appropriate lab tests and/or immunizations as a condition of my volunteer service.
I release, discharge and relieve DCH Health System from any and all claims whatsoever of any nature arising as a result of my volunteer services and all related activities.
I understand and agree that I will comply with all rules and standards of conduct that apply to hospital employees and independent contractors, including the hospital's policy on confidentiality which I have signed and submitted.
I shall be punctual and conscientious, conduct myself with dignity, courtesy and consideration of others, and endeavour to make my volunteer service professional in quality.
I have read and understand the assignment descriptions for the placements I would like to serve. I shall make my best effort to fulfill my commitment to the hospital by following the assignment descriptions and completing all assignments I accept.
I agree to attempt to resolve any problems related to my volunteer service with my assigned area's supervisor, and if unsuccessful, I will attempt to resolve any such problems with the Coordinator of Volunteer Services.
I understand the Coordinator of Volunteers Services reserves the right to terminate my volunteer status if I fail to follow policies, rules and regulations; if I am absent without prior notice; or if I have unsatisfactory attitude or appearance.
I understand I can be terminated for giving unsatisfactory service or for any other circumstances which, in the judgement of the Coordinator of Volunteer Services, would make my continued service contrary to the best interest of the Health System.
I shall abide by the dress and personal appearance policy included in the Volunteer Handbook and any department specific dress code identified by my assigned department.
I understand that DCH Health System offers medical services for treatment of illnesses, including but not limited to tuberculosis, hepatitis, and HIV, and I assume a risk that I might be inadvertently exposed to such diseases.
I HAVE READ, I UNDERSTAND, AND I AGREE
I DO NOT AGREE
© 2013 DCH Health System