??ࡱ? > ?? n p ???? m ? ?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? ?? - bjbjO?O? 4 -?c-?c ?? ?? ?? ? ? ? ? ? ? ? ? ???? ? ? ? 8 ) = ? ? 2 Q g g g g B B B G I I I I I I $ ? ? ? d m ? B B B B B m ? ? g g ? ? B : ? g ? g G B G Q ? g ???? ?/?#?? ???? | : i 3 ? 0 ? q , ! ? ^ ! ? ! ? ? ? B B B B B B B m m B B B ? B B B B ???? ???? ???? ???? ???? ???? ???? ???? ???? ???? ???? ???? ???? ???? ???? ???? ???? ! B B B B B B B B B ? ? : INCLUDEPICTURE "cid:image001.png@01D2F98F.8BADABE0" \* MERGEFORMAT Volunteer Service Agreement I agree to the following: I will use confidential information, as required by HIPAA laws, obtained while volunteering only as authorized by the hospital for the performance of my volunteer service. I will comply with AHCV practices as it is directed by state and federal regulations and pertains to my volunteer services. I offer and perform my services as a volunteer ? not as an employee without financial compensation. I will treat patients, guests, physicians, employees and fellow volunteers with a positive attitude with respect and integrity. I will adhere to the Volunteer dress code guidelines appropriate to the service area to which I am serving and wear my volunteer identification badge while volunteering. Exceptions to this may be off stage volunteers, i.e. gift shop buyers, sewing groups or yard sale preparation. I will attend and/or comply with all annual mandatory compliance testing and health screening requirements that are required to volunteer. I understand my services as a volunteer are limited to customer service and staff assistance, and that as a volunteer will never become involved in administering patient care to our patients and guests. I understand that I may end my service at any time by written notice. I understand that my services as a volunteer can be discontinued at any time. I understand that upon termination of service I am required to return Adventist Health property that includes identification badge. I understand that the complimentary meal that a volunteer may optionally receive during a volunteer shift is not a form of compensation and that the meal must be received on the same day as the shift that I have clocked in and out for. I understand that I have made a commitment to accept a volunteer assignment, and that if I fail to show for two consecutive scheduled assignments that I will be relieved of the assignment. I have read each of the above conditions and I am signing this agreement without reservation. Volunteer Name (Print First and Last): ________________________________________ Volunteer Signature: _________________________________ Date: ________________ Staff Signature: _____________________________________ Date: ________________ E F G H I J K U ] g ? ? 3 O U X b d ? ? ? 8 9 ? I J ? ? ? ? ? r { ? ? ? [ \ ? / 0 1 ? V r ? ? ? ? ? ? ? ? ? ???????????????ݽ????????ݵ??????????ݱ??????ݭ?ݩݥ????????? he? h6~ h?? h?O? h#i hr! h"? 6?hGA h'Qf hr! h?3? hr! 5?h?3? h"? 5?h?3? h"? h?/{ j h?D? UmH nH u h?D? j h?D? U ? I J K g h ? . ? ? ? 7 J ? ! ? ? ? / 0 1 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? gd"? gdr! &