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Home > Ways to Give > Volunteer > Volunteer Application

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Volunteer Application

MGH Health Foundation
The Women’s Board
Volunteer
- Volunteer Application
Observation Program
- Application to Observe a Health Care Professional

Volunteer Application

For questions regarding the volunteer application please call 301-774-8629 or email [email protected].

If you would prefer to submit this form via mail, please print the application and mail to:
Volunteer Services Department
18101 Prince Philip Dr.
Olney MD 20832
You will be contacted if an opportunity becomes available that fits your interests. All applicants must be age 15 or older. For questions regarding the volunteer application please call 301-774-8629 or email [email protected].
Applicant Information
Prefix*
Name*
First Last
I am 15 years of age or older:*
- Yes
- No
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone Number*
Cell Phone Number*
Email Address*
Background Information
Have you ever been employed or assigned to work at MedStar Montgomery Medical Center or any other MedStar Health facility?*
- Yes
- No
Where did you volunteer and for how long? Please include name used to volunteer if different from the name you entered above.
Do you have any relatives employed or volunteering at MedStar Montgomery Medical Center?
- Yes
- No
Name*
Department*
Relationship to Applicant*
Occupation/School History
Present Occupation/School*
If retired, what was your occupation prior to retiring?
Skills
Please select all skills that apply.*
- Computer
- Marketing
- Physical Therapy
- Public Speaking
- Microsoft Word
- Microsoft Excel
- Filing
- PowerPoint
- Accounting/Math
- Writing & Composition
- Other
Availability
Monday
- 8 a.m. to noon
- 4 to 8 p.m.
- Noon to 4 p.m.
- I am not available
Tuesday
- 8 a.m. to noon
- 4 to 8 p.m.
- Noon to 4 p.m.
- I am not available
Wednesday
- 8 a.m. to noon
- 4 to 8 p.m.
- Noon to 4 p.m.
- I am not available
Thursday
- 8 a.m. to noon
- 4 to 8 p.m.
- Noon to 4 p.m.
- I am not available
Friday
- 8 a.m. to noon
- 4 to 8 p.m.
- Noon to 4 p.m.
- I am not available
Saturday
- 8 a.m. to noon
- 4 to 8 p.m.
- Noon to 4 p.m.
- I am not available
Sunday
- 8 a.m. to noon
- 4 to 8 p.m.
- Noon to 4 p.m.
- I am not available
Accommodations
Are there any limitations on your activities?*
- Yes
- No
Please explain your limitations.
Volunteer Preference Area
Please select the area in which you would like to volunteer.*
- Main Information Desk
- Emergency Dept. Greeting Desk
- Surgery Waiting Area Desk
- Nursing
- Admissions
Reference Contact Information (cannot be a relative)
Reference Name*
Reference Address*
Reference Phone Number*
Why do you want to be a hospital volunteer?*
Emergency Contact Information
Emergency Contact*
Emergency Contact Relationship*
Emergency Home Phone*
Emergency Cell Phone*
I understand that I may occasionally be exposed to information of a confidential nature pertaining to patients in the course of my volunteer work. I further understand that this information is to be kept confidential, and I will not disclose such information or discuss it with anyone. I also understand that the casual sharing of patient information in public places or settings is inappropriate. The only exception may be taking telephone messages from patients or family members, or about patients/families, and passing such messages along to the appropriate staff member. All offers are made conditional on the satisfaction of completion of a new volunteer health screening, drug clearance, background check, and references.
Signature*
Date*
Thank you for your interest in MedStar Montgomery Medical Center!

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In conjunction with the Olney Boys & Girls Club, MedStar Sports Medicine and MedStar NRH Rehabilitation Network, we're offering a FREE seminar for parents and coaches! Join us from 6 p.m. to 8 p.m. on Thursday, June 8 for "Wellness & Nutrition for Young Athletes" and learn from MedStar's experts. Learn more and register here.

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MEDSTAR MONTGOMERY MEDICAL CENTER 18101 Prince Philip Dr Olney, MD 20832 855-633-0207

Improve your experience

Share this page:

Volunteer Application

Volunteer Application

Applicant Information

Background Information

Occupation/School History

Skills

Availability

Accommodations

Volunteer Preference Area

Reference Contact Information (cannot be a relative)

Emergency Contact Information