Volunteer Application

Contact Details

First Name

Last Name

Select an Address

Phone

Birthday

What languages, other than english, do you write and/or speak?

Tells Us About You

Describe your work experiences over the past 10 years. Or attach a resume

Please describe your volunteer experience

Add a resume

Upload File

What are your interests and hobbies?

Have you experienced a recent personal loss? If yes, how long ago?

Why do you want to work with those who are facing life threating illnesses or grief?

Please share what you feel comfortable with about your experience with personal loss

Hospice Volunteers may experience situations that could be triggering of their personal losses and grief. If you have had a personal loss/death of a loved one, please share how you feel your loss will affect your role as a Hospice Volunteer.

What is your understanding of confidentiality?

What drives your passion to volunteer with Hospice?

How did you become interested in Hospice?

Have you been a client of Hospice? If so please explain

Your Availability and Areas of Interest

What times are you available?

Depends on the day

Emergency Contact

Emergency contact's first and last name

Emergency contact's phone number

Emergency contact's relationship to you

References

Please provide 2 references. References must be someone who is at least 21 years old, have known you 2+ years and are not a family member of yours

Reference's first and last name

Reference's relationship to you

Reference's email

Reference's phone number

Best time to call

Refrence's first and last name

Refrence's relationship to you

Refrence's email

Refrence's phone number

Best time to call

Hospice Volunteer Policy and Procedures

I agree that I will not solicit my personal business, fundraising endeavors (for Hospice or otherwise), or practitioner services to clients of the Campbell River Hospice Society.

This agreement stands for current and past clients of the Campbell River Hospice Society. Any exceptions to this agreement must be discussed and agreed upon with the Executive Director of the Campbell River Hospice Society.

If any previous agreements have been made between you and a client of the Campbell River Hospice Society, we must be made aware before you begin providing services as a volunteer.

I confirm that I am not currently pursuing a career in becoming a Death Doula in the province of BC. If this changes, I understand that I must inform the Campbell River Hospice Society before pursuing a career as a Death Doula.

As a volunteer for the Campbell River Hospice Society, I understand that I will be exposed to confidential information about clients and their families.

I recognize that clients’ names are confidential, as is any information about them.

I understand that I may not discuss our clients with my significant other, friends, or family, nor will I reveal any information that could lead to identifying the client or their family.

I understand that a breach of confidentiality may be a sufficient reason for termination as a volunteer.

All persons who work with or may potentially have unsupervised access to children or vulnerable adults must consent to a criminal record check by the Criminal Records Review Program (CRRP).

When in the position of Direct Hospice volunteer, I understand that I will not discuss fundraising or financial information regarding Hospice and/or other organizations. If a client asks about Hospice fundraising or donations, I will refer them to our office for more details.

I understand that I will not transport a client by car or any other motor vehicle in my role as a Hospice Volunteer. If a client requires transportation, community resources can be provided to them.

I understand that it is not my role as a Hospice volunteer to provide guidance on a client’s Will or financial doings or to be present in any meetings regarding these subjects.

I agree to notify the Volunteer and Event Coordinator or the Services Coordinator if a client has begun to expect services beyond those provided in my role as a Hospice Volunteer, e.g., transporting clients around, contacting volunteers unnecessarily on a regular basis, etc.

As a Direct Hospice Volunteer, I agree with using Slack as a visitation communication tool when sharing basic client information. I agree to keep this tool private and confidential even when using it on a personal device. Screenshots, saving of conversations, sharing, or inviting new participants on Slack or sharing password/login details are strictly prohibited. Failure to comply may lead to the termination of my volunteer position with Hospice. If any privacy breaches are made, I agree to inform the Volunteer and Event Coordinator as soon as possible.

It is the policy of Campbell River Hospice Society (CRHS) that all volunteers will sign and abide by the following agreements:

-The CRHS Code of Ethics Volunteer Policy and Procedures

-Medical Assistance in Dying (MAiD) Witnessing Agreement

-MAiD Discussion Agreement

-Spirituality Discussion Agreement

-Confidentiality Agreement

-Non-Solicit Agreements (Death Doula, personal business and fundraising)

Your Signature in Agreement

Thank you, we will be in touch shortly!