Thank you for your interest in our 2018 Summer Volunteer Program.

We are very pleased you have chosen Crestwood Medical Center as a place of service. We know we will have a great group of committed volunteers assisting our patients and staff.

Enclosed in this packet you will find essential forms for application:

  • Volunteer Areas at a Glance – Use this document as a reference when selecting your preferred areas of service on the application form.
  • Application Form
  • Parent/Guardian Permission Form
  • Teacher/Counselor Recommendation Form

REQUIREMENTS TO APPLY – Please ensure you meet all application requirements before submitting an application.

  • High School or Middle School student between the ages of 14 and 18. Students must have been 14 by December 31, 2017.
  • At least a B grade average
  • Must commit to at least one full 3-week session (Monday – Friday, 4 hours a day). Our 2018 sessions will be June 4-22 and July 9-27.

Guidelines for New Volunteers & Application Process
Review the following instructions carefully. Please note that the requirements listed in section #4 are completed after the volunteer has been notified of their selection to the program.

1)Please complete the following prior to your interview. You will return your completed application packet to the person conducting your interview.

  • Application Form
  • Parent/Guardian Permission Form - signed by the parent or legal guardian insuring transportation to and from the hospital and understanding of other important program requirements.
  • Teacher/Counselor Recommendation Forms - signed and completed by a teacher or counselor. This form should be submitted directly to the Volunteer Department by the person completing your application through mail, fax, or email.

2)Follow the instructions below to schedule your interview using SignUp.com.

Interviews must be scheduled by Friday, April 27 at 5 PM.

  1. Enter this web address into your browser:
  2. Review the options listed and choose the time that works best with your schedule. You will sign up for ONE 15-minute interview slot.
  3. Sign up! You will NOT need to register an account or keep a password on Sign Up.

3)Interviews will be held on Saturday, April 28 at Crestwood Medical Center (One Hospital Drive, Huntsville, AL 35801) in the Conference Room located on the first floor, next to the Cafeteria. Please bring the completed application packet (detailed in #1) to your interview. You will sign in and wait for your name to be called in the Cafeteria.

4)Following interviews, volunteers will be notified of their acceptance to the program via email during the second week of May.

5)IF ACCEPTED, the following must be completed before the assigned volunteer session begins. More details will be provided to complete these steps. Do not complete these requirements until you receive further instructions.

  • A negative tuberculosis (PPD) screening test will be required to participate in the volunteer program. Once accepted into the summer volunteer program, a TB skin test can be administered by Crestwood on a scheduled day. The cost of the TB skin test is $15. If you have had a tuberculosis skin test (PPD) within the last 6 months, provide the Volunteer Department to fulfill this requirement.
  • A negative drug screening will be required to participate in the volunteer program. Once accepted into the summer program, the drug screening will be administered by Crestwood on a scheduled day. A photo id will be required. If you do not have a photo id, then a parent must accompany you to the drug screening. The cost of the drug screening is $25.
  • Proof of Immunizations – provide the Volunteer Department with a copy of your blue immunization card
  • Attend Orientation – held on the first day of your assigned session.

For questions, please contact Jasmine Duncan at

256-429-4076 or

Volunteer Areas at a Glance

Use this document as a reference when selecting your preferred areas of service on the application form. This is not a complete list of possible volunteer areas where Summer Volunteers may be assigned.

Day Surgery –Assisting patients by giving them drinks and crackers while they wait for discharge.

Emergency Department – Greeting and escorting patients, offering blankets and pillows to patients in the waiting room, refilling the blanket warmer, and assisting the triage nurse.

Visitors Entrance Information Desk – Greeting and escorting patients and visitors, directing visitors to the appropriate departments or areas of the hospital. Visiting patient rooms to offer assistance or small nominal items.

Outpatient Imaging Center – Greeting, escorting patients and visitors to the appropriate areas of the imaging department.

Surgery Waiting Area - Escorting patients to various departments in hospital and escorting family to patient.

All Patient Floors: Orthopedic Patient Floor, Medical Patient Floor, Oncology Patient Floor, Cardiac Patient Floor, Maternity Patient Floor, Intensive Care Unit/Waiting Areas, Spine/Bariatric/Neuro Patient Floor – Assisting patients by answering call buttons, delivering meal trays, refilling water pitchers and warm towels.

Pre-Op – Escorting patients from the waiting area to one of the three pre-op areas. Assisting the staff with copying, preparing packets and preparing stretchers.

Recovery – Answering phone, escorting family to patient, and compiling patient packets.

Registration Escort – Greeting and escorting patients, compiling patient packets, labeling folders and forms.

Special Procedures - Answering phone, escorting family to patient, and compiling patient packets.

Women’s Center (Breast Care/Mammography, etc.) – Greeting and escorting patients, assembling registration packets, and maintenance of literature in the Family Resource Library.

2018 Teenage Summer Volunteer Application Form

Name: ______

Phone: ______

Email Address: ______

Summer Session Dates: Please rank your 1st and 2nd choice for summer sessions.

_____Session 1: June 4-22 (3 weeks, Monday - Friday, 4 hours each day)

_____Session 2: July 9-27 (3 weeks, Monday - Friday, 4 hours each day)

Morning or Afternoon Shift: Please rank your 1st and 2nd choice for shift times.

______Morning Shift: 8 AM – 12 PM

______Afternoon Shift: 12 PM – 4 PM

Areas of Volunteer Service: Please check all areas of interest:*

[ ]Visitors Entrance Information Desk[ ]Surgery Waiting Area

[ ]Emergency Department [ ]Special Procedures

[ ]Day Surgery[ ]Registration Escort

[ ]Imaging Center[ ]Women’s Center

[ ]Orthopedic Patient Floor[ ]Medical Patient Floor

[ ]Oncology Patient Floor[ ]Progressive Cardiac Patient Floor

[ ]Maternity Patient Floor[ ]Recovery

[ ]Intensive Care Unit/Waiting Areas[ ]Spine/Bariatric/Neuro Patient Floor

* Refer to the Volunteer Areas at a Glance document on page 3 for more details about volunteer responsibilities in each area.

1. Why are you interested in enrolling in this program? ______

2. Are you looking at healthcare as a possible career choice for the future? □ YES□ NO

3. If yes, what type of healthcare are you most interested in pursuing? ______

4. What are your hobbies/interests? ______

______

5. Do you need special accommodations due to medical limitations, disability, dietary constraints, or other restrictions? If yes, please explain. ______

List and describe two reasons why you believe you should be accepted into this program.

  1. ______
  2. ______

Crestwood Medical Center

Parent/Guardian Permission Form

Your child has the opportunity to participate in the Crestwood Summer Volunteer Program.

  • I will ensure his/her transportation to and from the hospital. I understand that he/she cannot arrive at the hospital more than 30 minutes prior to his/her assigned volunteer shift(s) and must be picked up promptly at the end of the volunteer shift.
  • I also understand that teenage volunteers are not allowed to leave the Crestwood campus while on shift.
  • My child will attend a scheduled Orientation before their assigned session in order to volunteer.

PARENTAL/GUARDIAN SIGNATURE

I hereby permit my son/daughter/charge ______to participate in the Teen Volunteer Program. I also give permission for a drug test to be completed on my son/daughter/charge for participation in this program. I further release the Hospital from any legal or other responsibilities for any injuries, act, or incidents involving the volunteer.

Parent/Guardian Signature ______Date ______

Phone Number ______

In addition, I give the following permissions:

_____ Permission for his/her photograph to be taken and possibly published in a Crestwood publication.

_____ Permission for him/her to accept a volunteer placement at an off-campus location. This may require him/her to walk a short distance to a Crestwood area, separate from the main hospital building.

Crestwood Medical Center

Teacher/Counselor Recommendation

Thank you for taking the time to complete this recommendation. We ask that you carefully consider the criteria when evaluating your student. We are seeking students who are responsible, dependable, caring and have the ability to provide high-quality service to our patients, guests and staff.

Please return by April 20:

  • By Mail toJasmine Duncan, Volunteer Services
    Crestwood Medical Center, One Hospital Drive, Huntsville, AL 35801
  • By Email to
  • Or return to the applicant in a signed/sealed envelope to be submitted along with their application

School Name: ______

School Address: ______

Student’s Name: ______
Grade Level: ______Student’s Overall GPA: ______

Please circle the appropriate rating:

School AttendanceExcellentGood AverageFair Poor

PunctualityExcellentGood AverageFair Poor

ConductExcellentGood AverageFair Poor

DependabilityExcellentGood AverageFair Poor

Follows InstructionExcellentGood AverageFair Poor

Accepts ResponsibilityExcellentGood AverageFair Poor

Shows InitiativeExcellentGood AverageFair Poor

Do you recommend this student as an applicant for the Crestwood Summer Volunteer Program?

□ YES□ NO

Comments:______

Name & Position: ______

Signature: ______

Business Telephone: ______Ext ____ Email: ______

For questions, please contact Jasmine Duncan at 256-429-4076 or

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