Therapy Team Volunteer Application for Handlers

Thank you for your interest in volunteering at UCHealth at University of Colorado Hospital with your Therapy Dog. Therapy Dogs and their handlers play an important and meaningful role in providing service to patients and their loved ones. We hope you find your experience here to be valuable and worthwhile. For more information on the process of becoming a volunteer, How do I become a volunteer at UCHealth?

Next Steps

Please complete all required fields on the application below before submitting. We do not recommend entering and submitting an application using a cellphone. There is a separate application type for your therapy animal as they need their own file and badge too.

Once you have submitted your application, login using the email and login ID you created.
Download the reference form documents.
Complete the Online Orientation Training (there are two packets each with a quiz at the end.)
Upload two References under the Upload File tab when you log into the system with the UserID/email and password you will set up below at the beginning of the application.
- Your reference forms may not be completed by a relative.
- We prefer references from adults, supervisors, teachers, church leaders, troop leaders, co-workers or someone who has known you for a long time.
- We must receive these references before you may begin volunteering.

We look forward to meeting you and welcoming you to our team of volunteers making a difference at UCHealth. If you have any questions, please feel free to call our office at 720.848.1886.

Volunteer Services Department
Jenny Ricklefs, Manager, 720.848.4068, Jennifer.Ricklefs@uchealth.org
Melissa Strickland, Volunteer Coordinator. 720.848.4070, Melissa.Strickland@uchealth.org
12605 East 16th Ave, Mail Stop F771, Aurora CO 80045

Required fields are noted in red.

User ID

User ID (verify)

Password

Password (verify)

CONTACT INFORMATION

* First name

Middle initial

* Last Name

Preferred Name if different from First Name:

Gender

* Address:

Apartment #

* City:

* State

* Zip code:

* DOB

* SSN

* E-mail:

* Cell Phone

Home Phone

Work Phone:

What is the best way to contact you?

Please upload a photo of yourself, make sure it is loaded upright. We send this photo to the unit you will be working to help them prepare.

EMERGENCY CONTACT

Please provide the name and number of someone we may contact in case of an emergency.

* Name:

* Phone:

* Relationship

EMPLOYMENT STATUS

Select your Employement Status:

Current Employer

Current Position/Title

EDUCATION

Highest level of education completed

College/University Name:

Degree/Major:

* Why do you wish to volunteer at UCHealth?

* List any previous volunteer experience:

How did you hear about volunteering at UCHealth?

EXPERIENCES AND INTERESTS

Patient Care Services

Clerical Skills

Other Skills

Other skills, interests or special training:

Identify any special skills that might add to your volunteer experience at UCHealth:

AVAILABILITY

Select times when you are available to volunteer:

APPLICANT E-SIGNATURE

I acknowledge that I am volunteering of my own free will and do not expect any monetary reimbursement. I verify that the information provided is accurate to the best of my knowledge. I authorize UCHealth - Metro Denver and its agents to confirm all information provided on the application.

* Therapy Tails Handler Applicant - please type your name in this field as a form of electronic signature

* Date:

PHOTO CONSENT: This is to certify that I give permission to UCHealth to use my image and/or my therapy animials image for news media, marketing, public relations, and/or hospital business purposes.

* Therapy Tails Handler Applicant - please type your name in this field as a form of electronic signature

* Date: