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Hospice volunteer form

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Hospice volunteer application

Novant Health Hospice is accredited by the Joint Commission on Accreditation of Healhcare Organizations and is the only hospital based inpatient and outpatient hospice program serving Mecklenburg County and it's surrounding areas. As a result, all volunteers must comply with the same Human Resource requirements, orientation and training as employees.

After the application is received and all references are verified, the volunteer coordinator will contact you to schedule an interview. This interview is informal and is intended to help us learn more about you, and to discuss current volunteer opportunities and the orientation process.

Completed applications do not guarantee placement in a volunteer position. All accepted applicants must complete 12 hours of orientation, a health screening, criminal background check and fingerprinting.

For questions, please call 704-384-6478.

*=required field
Volunteer Name*
Patient’s Name (if applicable):
Date of Contact*
Start time
Finish time
Total time*
Total Miles Driven (if applicable)
Type of activity:*




Other:
Location: *


Other:
Services provided:* (check all that apply)




+ Services requiring competencies and/or special licenses/certifications.

Volunteer comments Please provide feedback regarding your visit, phone call or bereavement session. (Mental status, family involvement, and ability to cope). Also include conversations around veteran experiences (if applicable). Immediately notify the office of any incidences or issues in which you become aware, i.e. falls, family or patient circumstances or anything which you may be concerned about.
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