Hospice Services of Lake County Providing hope, quality of life and compassionate care in our community for over 40 years Sooner is Better Patients get the most benefit from hospice support when hospice is called early. Call today to see how you or your loved one might benefit from hospice care. 707-263-6222 or 1-800-900-8820 Apply to Become a Volunteer Download Volunteer Application Form (PDF) Volunteer Application Online Form Volunteer Application Online Form Name * Name First Name First Name Last Name Last Name Mailing Address (Street Address, Apartment #) * City * State * CALIFORNIAOther Zip Code * Email * Phone Number (With area code) * Birthdate * Are you currently employed? * Yes No If you are working, may we contact you at work? * Yes No N/A Areas of Interest (Check all that apply) * Direct Patient/Family Support Administrative, Clerical, misc Bereavement/Grief Support (including schools and camps) Lakeport Thrift Store Clearlake Thrift Store Middletown Thrift Store Special Events Community Relations, Fundraising Board, Leadership Do you speak a language other than English? * Yes No If you speak a language other than English, please state which one and level of fluency. Are you a veteran? * Yes No Do you have experience with addiction and recovery? * Yes No How did you hear about Hospice? (Check all that apply) * Facebook Instagram In the News / Newspaper On the Radio From a Friend AARP From another Local Organization Through school (K-12 or College) Other All employees and volunteers are required to pass a drug screen and background check. Are you willing to submit to a drug screen and background check at our expense? * Yes No List any special skills and training that are relevant to your area of volunteer interest. Why are you interested in volunteering for Hospice? Declaration: As a volunteer I realize that I am subject to a code of ethics similar to that which binds the professional in the field in which I work. I, like them, assume certain responsibilties and expect to account for what I do in terms of what is expected of me. I understand that any information that is disclosed to me while assisting Hospice Services of Lake County is confidential. I agree to respect the confidentiality of any client information I may acquire int he course of my volunteer activities. I interpret "volunteer" to mean that I have agreed tow ork without compensation in money but having been accepted as a volunteer worker. I agree to respect the confientiality of any client information I may acquire in the course of my volunteer activities. Do you agree with these statements? * Yes, and I will sign a form upon acceptance. No Submit If you are human, leave this field blank.
