Pet Therapy Adult Volunteer Application
Thank you for your interest in volunteering as a pet therapy team at
Middlesex Health.
Please complete all required fields below
to establish your applicant profile and apply for a volunteer position.
Applications are reviewed by our Volunteer
Coordinator in a timely manner.
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Emergency Contact Information
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Current/Most Recent Employer Information
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Daily Availability
Please tell us when you are available. (Check all that apply)
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Applicant Statement
Please check the box below to acknowledge and agree with the following statements:
- I understand incomplete applications will not be considered for processing.
- I understand that documentation of proof of vaccination of measles, mumps and rubella (MMR) vaccine or laboratory evidence of immunity, proof of vaccination of 2 doses of the Varicella vaccine (vaccine for chicken pox) or laboratory evidence of immunity or history of chickenpox based on healthcare provider diagnosis, and a Tuberculosis Screening results via either a 2-step TB (PPD) skin test [If positive, chest X-ray is required], or Quantiferon Gold (preferred) will be required to volunteer with Middlesex Health.
- I understand that a flu vaccine is required in season.
- I understand that I will provide a copy of my canine's vet records and pet therapy certfication.
- I agree to abide by the policies and regulations of Middlesex Health and the Volunteer Services Department and to participate in orientation and training required by Middlesex Health.
- I will hold as absolutely confidential all information that I may obtain directly or indirectly concerning patients or personnel and not seek to obtain confidential information from a patient.
- I understand that I may be dismissed from my duties if I fail to comply with hospital policies and procedures, willful wrongdoing or negligence and/or performing duties outside of my service guidelines, inappropriate behavior, or any other circumstances deemed contrary by the Director of Volunteer Services to the best interests of the hospital.
- I authorize Middlesex Health to take my photograph in relation to my volunteer position.
Thank you for submitting your application. A confirmation message has been sent to your email.