Therapy Team Volunteer Application for Handlers

Thank you for your interest in volunteering at UCHealth University of Colorado Hospital with your Therapy Dog! Therapy Dogs and their handlers play an important and meaningful role in providing care to staff, patients and their loved ones. We hope you find your experience here to be valuable and worthwhile.

New Volunteer Sign Up Process

**Two applications are needed for Therapy Dog Teams. This application is for you, the handler. The second application is for your dog.**

Steps 1-8 need to be completed before beginning volunteering. Be sure to reference these steps throughout the application process to keep track of where you are in the process..

Step One: Complete the online application below.

Step Two: Review the University of Colorado Volunteer Handbook .

Step Three: Log into your account and complete the online required education modules with the associated quizzes. Complete the HIPAA training.

Step Four: L og into your account and read and complete the following agreements:

Handbook Acknowledgement
Dress Code
Confidentiality Agreement
Code of Conduct
Uniform and Badge Policy

Step Five: Complete an application for your therapy dog. There is a separate online application choice under Therapy animal teams.

Step Six: Request an interview with you and your therapy animal. Email uchvolunteerservices@uchealth.org with the subject line: "Request for an in-person interview".

Step Seven: Complete the Volunteer Startup Checklist.

Step Eight: Schedule in-person orientation - you will begin by working with another pet therapy team.

Disclaimer: If this to-do list is not completed within 30 days, we reserve the right to remove your application from our records and discontinue the process.

If you have any questions, please feel free to call our office at 720.848.1886.

Volunteer Services and Shadowing Department
Jenny Ricklefs, Manager
Amanda Murphy, Coordinator
April Phinny, Coordinator

uchvolunteerservices@uchealth.org
12605 East 16th Ave, Mail Stop F771, Aurora CO 80045

New User Details

User ID

User ID (verify)

Password

Password (verify)

CONTACT INFORMATION

* First name

Middle initial

* Last Name

Preferred Name if different from First Name:

Preferred Pronouns

* Address:

Apartment #

* City:

* State

* Zip code:

* DOB

* Last 4 Digits of SSN

* E-mail:

* Cell Phone

Home Phone

Work Phone:

What is the best way to contact you?

* Please upload a photo of yourself. 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:

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:

To expedite the interview process, please answer the following questions.

* Why do you wish to volunteer at UCHealth?

* What previous volunteer experiences do you have, what challenges did you meet and how did you make a difference for others?

* Tell about a time in your work life or volunteer life when you worked on a team. What role did you play and why?

* What are your three greatest accomplishments in your life so far?

* What special, wonderful and unique qualities will you bring to make a difference for our patients?

AVAILABILITY

Select times when you are available to volunteer:

REFERENCE INFORMATION

PLEASE NOTE: A VOLUNTEER REFERENCE REQUEST WILL BE SENT TO THE CONTACTS PROVIDED.

REFERENCE 1

* Name

* Organization name or relationship to applicant

* E-mail

REFERNCE 2

* Name

* Organization name or relationship to applicant

* E-mail

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

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

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

* Date: