Innovation Partner Volunteer Application

Dear Innovation Partner, 

Thank you for all you do in partnership with UCHealth.  Completing this process will give you the ability to be on-site at a UCHealth facility.  We value our relationship and want to equip you with the knowledge and access you need to be safe as you interact with staff and focus on enhancing our collaborative projects.   Please remember, hospitals and clinics are regulated entities and must meet state and federal requirements to ensure patient safety.  This process and our partnership fall under those regulations. 

Steps:

  1. Complete this Innovation Partner Application - UCH.
  2. Upload an employment verification (photo of badge ID, pay stub, or something with company letterhead).
  3. Watch the two training modules and complete the tests at the end.
  4. Complete the HIPAA education and test.
  5. Complete the background check form (will be emailed from Verified Volunteers once your application has been reviewed).
  6. Come in for a 40 minute meeting to review requirements to be on-site, learn the proces for checking in and out when you are on-site, get your photo taken for your badge and access to the hospitals and clinics, and complete a health screen including a blood test for TB, vaccinations, flu shot, and drug screen. If you would prefer to upload documents showing you have been tested recently for TB, you have a current flu shot, your vaccinations are up to date and you have completed a 10 panel drug screen, you may do so and alleviate the need to complete the health screen. 

Thank you again for our partnership and your cooperation with this process.

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,Coordinator 720.848.4070, Melissa.Strickland@uchealth.org
12605 East 16th Ave, Mail Stop F771, Aurora CO 80045

Required fields are noted in red.
CONTACT INFORMATION
EMERGENCY CONTACT
Please provide the name and number of someone we may contact in case of an emergency.
EMPLOYMENT STATUS
EDUCATION
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.
I certify that all responses on this document are true to the best of my knowledge. I agree that this information may be verified by UCHEALTH Volunteer Services. I understand that any misrepresentation of information constitutes cause for separation or termination from the Innovation Partner program.
After submitting this application, please login to the volunteer site at https://uclive.vsyslive.com using the email and password you entered above. Once you are logged in, you can upload any required documents if needed, and complete your online orientation and HIPAA training. Thank you!