Volunteer Application

*Required
1 Application
2 Confidentiality Statement
  • General Information

  • I Would Like to Volunteer...

    (Check all that apply)
  • Work Experience

    Please list your last 2 employers.
  • Personal References:

    Please list name and phone number of 2 people that we can call.
  • PLEASE NOTE:

    1. PCHS will require your signature and agreement to protect patient/client confidentiality at the time of orientation.

    2. PCHS is a drug-free, smoke free, alcohol free workplace.