Welcome to Rochester General Hospital Volunteer Services Department
Adult (Non-Student) Volunter Application
Employment and Educational History
Former Rochester Regional Employee?
Approximately when did you leave Rochester Regional Health
If "yes," what is the first and last name of your last leader/boss?
When are you free to volunteer? (Check all that apply.)
How did you hear about the program
Why do you want to volunteer? What is your hope/goal?
Have you ever been known by any other name?
If yes, what name were you known by?
When were you known by that name?
Please read and sign:I understand that any falsification of information on this application may result in immediate termination of the application/on-boarding process or as a volunteer with the Rochester General Health System.I authorize the Volunteer Services Department to contact my references.I agree that my acceptance as a volunteer is contingent upon my passing a medical examination. Please state below any physical condition you have which should be considered when you are assigned a volunteer position in the hospital, or which we should know in case of emergency.I understand that a volunteer is expected to observe confidentiality with respect to all patient information at all times, and that failure to do so may result in my personal liability to the patient and/or the hospital.
For office use only:
's Volunteer Management Web Interface by