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Confidentiality Agreement and Applicant Acknowledgment 

Confidentiality Statement
Your job may bring you into contact with patients, patient records and information or place you in a position to hear discussions of patient care. Any information you see or hear concerning a patient, a patient's diagnosis, condition, treatment, financial or personal status is STRICTLY CONFIDENTIAL. Patients desiring privacy are to be granted privacy. Personnel who discuss the presence of a particular patient in LMH Health may be violating that right of privacy.

For this reason, you are not to discuss inside the hospital, outside the hospital, or on the internet, the identity or condition of any patient with anyone not directly concerned with their care. You may discuss such information only as part of your assigned duties. Medical information should never be disclosed to anyone. A breach of these rules violates hospital and medical ethics and could have legal consequences for both you and the hospital.

I understand and agree to abide by the above policy. I understand that if I violate the above policy, the Volunteer Services Department may discipline me, up to and including asking for my resignation as a volunteer.

Background Release
LMH requires all new volunteers and employees to have a background screening. We utilize an outside screening company that and we will send you a link to complete the process as part of your orientation process. The cost for the screening for new volunteers is $35.00. LMH agrees to pay for $20.00 of your screening. We ask new volunteers to partner with us and pay the remaining $15.00 when you do the screening.

Applicant Acknowledgement

Believing that the hospital has real need for my services as a volunteer worker, I will be punctual and conscientious in the fulfillment of my duties and accept supervision graciously. I understand that I am making a commitment of no less than 3 months or 40 hours of service to the hospital. Less of a time commitment represents a waste of resources for the hospital as it does cost money to prepare me for my volunteer assignment. I will conduct myself with professionalism, responsibility, integrity, dedication and excellence. I will endeavor to make my work of the highest quality and uphold the traditions and standards of this hospital.  

I have read the information above and I will commit to providing service to LMH Health, following the guidelines and standards of the organization. The information I have provided here is true. I understand that any false statement or material omission will impact my ability to start and/or keep volunteering at LMH.

Once you submit your application, Volunteer Services will be in touch soon to follow up. Thank you!