Hospice Volunteer Opportunities

Oakland Hospice Volunteer Form

Please complete and submit the form below to volunteer with Oakland Hospice. Also complete and attach the Criminal Background Consent form when you submit your application.

Name*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Date of Birth*
Date Format: MM slash DD slash YYYY
Driver's Liscence Number*
Are you 18 years of age?*
- Yes
- No
Employer
School
Emergency Contact / Relationship*
Please list special skills, talents, hobbies and/or interests*
What type of volunteer service are you interested in providing?*
- Direct Patient Care
- Administrative Tasks
- Bereavement Support
Availability*
- Daytime
- Evenings
- Weekends
Please list any limitations
How did you hear about this opportunity?
Upload Background Check Form*
Accepted file types: jpg, gif, png, pdf.
Please provide two references (non-relatives) that you have known at least one year.
Reference #1
Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Email
Reference #2
Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Email
Parent/Guardian Signature*
Date*
Date Format: MM slash DD slash YYYY
Signature*
Date*
Date Format: MM slash DD slash YYYY
Consent*
I agree to the volunteer agreement.
I understand as a volunteer I will not be entitled to monetary compensation for the work I perform. As a Volunteer, I realize that I am subject to a code of ethics like that which binds the professionals in the field in which I volunteer. I understand that any information that is disclosed to me while assisting as an Oakland Hospice Volunteer if confidential.

If you have any questions or need additional information, please contact:

Jeanne Edwards – Volunteer Coordinator
Oakland Hospice
7125 Orchard Lake RD., Ste 222
West Bloomfield, MI 48322
248-865-9418
jeanne.edwards@oaklandhc.org

Oakland Hospice Volunteer Form

Please provide two references (non-relatives) that you have known at least one year.