Only applications for volunteers who will have no patient contact are being accepted at this time. Please only complete this application if you will volunteer in an area where patient care does not occur. 

Due to a current backlog for required clinical clearance that is provided for volunteers by Occupation Health Services, applications for clinical-based volunteers have been closed and will resume in early February. Please check our website for updates. For questions, please reach out to our office at umhs-volunteer@med.umich.edu or 734-936-7912 to connect with a volunteer coordinator.

 

 

 

PRE-ASSIGNED VOLUNTEER APPLICATION

Required Fields are marked with an asterisk (*)

Volunteer Information

Citizenship and Visa Information

NOTE: Please upload a copy of your visa with at least one form of supporting documentation. 

Emergency Contact Information

Criminal Records Check Information

Placement Information

NOTE:  Work with Patients means "in the room" with Patients/Families/Visitors/Study Participants.

Languages Spoken

References

Please give three character references (they could be work, academic, or personal) who can respond to our inquiry about you.

Reference #1

Reference #2

Reference #3

Proposed Schedule

Note: Maximum 1 year (Annual Update required if extending past 1 year)
Note: Minimum 40 hrs or 90 days, whichever comes first
Certification
I certify that my answers are true and complete to the best of my knowledge. I agree that this information has been verified and references may be contacted by Michigan Medicine Volunteer Services. 

 

I, the undersigned, authorize the University of Michigan, on behalf of Michigan Medicine, to conduct a criminal history check and review of the Federal Exclusion Lists. These checks will be performed to evaluate whether I am qualified to volunteer at the University of Michigan. 

I understand that Michigan Medicine will contract with an outside vendor to conduct these investigations utilizing names and identifiers to determine the existence of any arrest resulting in conviction and furnish a response to Michigan Medicine.

I also understand that I may withhold my permission and that in such a case, no investigation will be done, and my application for volunteering will not be processed further. 

Misrepresentation of facts constitutes cause for separation from Volunteer Services.

NOTE: This application expires in 30 days. If the volunteer applicant does not respond to required onboarding actions, the application must be resubmitted to Volunteer Services.