VOLUNTEER INFORMATION
EMERGENCY CONTACT INFORMATION
VOLUNTEER INFORMATION
*Are you a returning volunteer?
EDUCATION AND EMPLOYMENT INFORMATION
PATIENT MENTOR APPLICANT SHORT ANSWER 
PHOTO RELEASE:
As a Harris Health volunteer, I realize that my image may be taken at hospital celebrations and other media events. I give my permission to the Harris Health System Director of Volunteer & Guest Services and the Administrative Director of Corporate Communications to use my image in any appropriate and related materials that will promote or otherwise publicize the Volunteer & Guest Services department or Harris Health.*
BACKGROUND CHECK AUTHORIZATION:
Choose if you have ever been convicted of or been on defferred adjudication for, or are you now either awaiting trial for or on deferred adjudication for, a felony or misdemeanor.
CONFIDENTIALITY AGREEMENT:
I agree to use confidential or proprietary information only as needed to perform my volunteer duties.  This means I will not access confidential or proprietary information without legitimate need/permission, nor in any way divulge, copy, release, sell, lend, revise, alter, or destroy any confidential or proprietary information belonging to Harris Health System.  I understand that I will be automatically dismissed as a volunteer if I do not respect my responsibility for maintaining confidentiality.

 

If accepted as a Harris Health System Volunteer, I agree to the following:

[ clear ]