Society for Healthcare
Volunteer Leaders
If you have a dept that wants a volunteer do any of you use a volunteer request form?
If so, would you be willing to share a copy with me?
Thanks in advance.
Jimmie Beauchamp
Washington Regional Medical Center
Fayetteville, AR 72703
My email is jbeauchamp@wregional.com
Fax 479-463-1565
I have used a request form in the past, although we dont really use it now. This is it:
Name of Department :
Location of Department : SJH SJE SJJ Contact Person : Contact Phone # : Contact Email :
Do you have "A Guide to Your Volunteers" manual in your department? Yes No Don't Know Frequency Volunteer needed : One Time Short Term On-Going Dates Needed : Start Date End Date Times Needed (Check All that Apply) : 6A-9A 9A-12P 12P-3P 3P-6P 6P-9P Other: From To Number of Volunteers Needed Per shift : Does this assignment have an Assignment Description with the Volunteer Office : Yes No Not Sure If we do not have an assignment description in the Volunteer Office, Please list all duties for which the volunteer will be responsible : Are there any qualifications, education, skills necessary for the volunteer to have? If so please list : May this assignment be filled by (Please check all that apply) : Teenager 14-15 Teenager 16-17 No Teens Please This position is (Check One) : Urgent Important Helpful Not a High Priority
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