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Dear Prospective Teen Volunteer: I want to personally welcome you to Adventist GlenOaks Hospital.

Thank you so much for your interest in volunteering. It is much appreciated. Our goal at Adventist GlenOaks Hospital is to provide our patients and their families with such a positive experience during their stay that they will return for future care and recommend us to others in the community. Thats where YOU come in. Volunteers can make such an important impact on the environment in a hospital. Whether taking a lost family member to a patients room, or just a friendly greeting- these are the things that we can do to set Adventist GlenOaks Hospital apart from the rest! All employees and volunteers at Adventist GlenOaks Hospital are taught our S.H.A.R.E. principles: Sense peoples needs before they ask Help each other out Acknowledge peoples feelings Respect the dignity and privacy of others Explain what is happening At Adventist GlenOaks Hospital, we are blessed to have the most compassionate and caring volunteers around. To ensure this, we have an extensive screening process that can take up to six weeks to complete. After an application is received, references will be checked prior to scheduling a personal interview. Below is a checklist of things to remember as you complete our application: Please read, sign and date the attached information on S.H.A.R.E principals BEFORE completing the application. Thoroughly completed application Provide TWO references on the forms provided (we will mail directly to your contacts) Provide a copy of state-issued Drivers License or ID Card OR Student ID Card Return ALL materials to my attention either through the mail or drop off to the front desk Once your references have been verified, I will call to schedule a personal interview with you and your parents. In order for us to be in compliance with certain regulatory agencies, it is necessary to complete a criminal background check on new volunteers. You will be asked to complete the criminal background check authorization form during your interview. Once you have been invited to serve as a volunteer, you will be required to take a TB test, attend a three hour orientation and receive on-the-job training. Orientations are held on the 4th Tuesday of each month from 3pm to 6pm. Please understand that you must have completed all of the aforementioned requirements PRIOR to being allowed to serve as a volunteer. If you have not heard from us within three weeks of submitting your application, please contact me by calling (630) 545-4992 or via email at stephanie.murrill@ahss.org. Thank you again! I look forward to meeting you. Sincerely, Stephanie Murrill Volunteer Coordinator *PLEASE NOTE: THE VOLUNTEER OFFICE IS OPEN ON TUESDAY AND WEDNESDAY FROM 8:30AM TO 5:00PM OR BY APPOINTMENT.

Standards of Behavior
Adventist Midwest Health is on a journey that we call Transforming Care ~ Transforming Lives. Our goal is to improve employee engagement and patient satisfaction by putting the patient experience at the core of everything we do. To that end, were asking our existing employees and every job applicant to pledge to practice the following standards of behavior. These standards are common-sense actions that follow the SHARE principles: Sense, Help, Acknowledge, Respect and Explain. By taking these actions every day, we demonstrate our commitment to fulfilling Adventist Midwest Healths mission of extending the healing ministry of Christ.

ense (Service Excellence) ~

Anticipates the needs of Use the AIDET principle to guide communication with our customers and guests:

others before the moment of contact to advance a thriving culture of service

excellence and unity. To demonstrate Service Excellence, I will: Provide exceptional care and to exceed the expectations of customers, patients and co-workers. I will not say, That is not my job. Offer assistance to escort a patient, guest, or family member when they appear to need direction, or find someone who can. I will meet the customers needs as quickly as possible. Adopt and promote AIDET in all customer interactions. Extend a friendly greeting to everyone, every time. Take ownership and be responsible for the outcomes influencing the experience of each customer by paying attention to personal details. Be committed to my own personal and professional development by seeking new knowledge and skills to enhance my performance. I will take pride in the organization and my impact on the patient experience.

Acknowledge the person Introduce yourself, utilizing your name, credentials, etc. Duration expected for the intervention, interaction or wait Explain what you are doing to or for the customer Thank the customer for choosing Adventist Midwest Health

elp (Teamwork) ~ Develop a cooperative


relationship among co-workers and departments to produce positive

patient outcomes at every point of the patient experience. To demonstrate Teamwork, I will: Acknowledge and appreciate each team members contributions with my words and actions. I do not gossip or talk negatively about others. Look for and act upon opportunities to help others and set an example of cooperation expected in the workplace. Actively seek solutions to problems, enlisting help when necessary rather than blaming or making excuses. Coach in private and commend in public. Be a loyal team member by treating everyone as a professional recognizing that we all have areas of expertise. I will not belittle peoples work.

cknowledge (Empathy) ~ Convey understanding and


sensitivity to our patients and co-workers. To demonstrate Empathy, I will:

Respond to Service Recovery opportunities and strive to exceed the needs of others by using HEAL: Hear them out Empathize Apologize Leap into action

Acknowledge and anticipate the needs of others by asking, Is there anything else I can do for you? I have the time. I will not allow anyone to feel ignored. Take time to listen without judgment and understand what patients, families and co-workers are experiencing. Recognize that any illness or even routine testing is stressful for the patient and their family. I will strive to relieve stress and not add to it. Apologize for delays, waits, inconveniences, or mistakes. I will provide an explanation where possible and offer immediate updates when changes occur.

espect (Courtesy) ~ Accept the cultural, spiritual and intellectual diversity of patients and co-workers by
displaying inclusive actions and attitudes that encourage strong personal connections. To demonstrate Courtesy, I will:

Be sensitive to the diversity of cultures, traditions, ideas, beliefs and accepting of these differences by using a courteous tone of voice and body language that conveys interest and attentiveness. Respect our clients right to privacy and dignity by creating and maintaining a secure environment during each communication and public interaction. Hold in confidence all private communication, information and interactions between co-workers, patients and leaders. Ensure that all equipment and supplies are customer ready while practicing safety as a courtesy to my team members, patients, myself and all others. Keep my working environment well maintained, clean and uncluttered; I will be responsible in utilizing my time and resources by returning all equipment clean and ready for the next person. Maintain a professional appearance that reflects respect for our customers and the organization.

xplain (Communication) ~

Demonstrate strong interpersonal skills in every aspect of daily work

activities to project a positive image as a representative of the organization. Be committed to listening attentively to both

verbal and nonverbal messages. To demonstrate Communication, I will: Deliver messages to customers and co-workers with courtesy, clarity and care. Explain information to all customers and co-workers with patience avoiding technical or professional jargon. I will speak in a caring tone and use language that is easily understood. Observe customers and visitors with special needs and have those needs addressed by the appropriate department (i.e. translators, interpreters, sensory-impaired assistance). Acknowledge and respond to e-mail, voicemail, telephone, and other forms of communication in a professional, pleasant and timely manner. Support verbal instruction with written or educational materials where appropriate to patients, customers and co-workers.

As an AMH employee, I agree to abide by these Standards of Behavior and will encourage my team to do the same.
Employee Name (Print): __________________________________________
Employee Name (Sign) : __________________________________________ Date: _______/________/______________

TEEN Volunteer Application Form


(Must be 16 years old to volunteer) USE BLACK INK AND PRINT LEGIBLY

Date:_____________________ Name:_____________________________________________________________________________________________ Address:_____________________________________________________________________________________________ Street City Zip Code Phone: _______________________ _______________________ Best Time to Call: _______________________ Home Cell/Business Birthdate: ______________________ E-mail:____________________________________________________________ High School: _______________________________ Expected Graduation Date: ___________________________ Reason(s) for wanting to be an Adventist GlenOaks Hospital Volunteer: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ Please list if you have volunteered for other groups (i.e., Church, Schools, etc.) and briefly describe your volunteer duties for each group. _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ List special skills, training, interests, foreign languages, or hobbies: _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ How did you hear about our volunteer program? Self-referred Friend___________________________________ Brochure Newspaper _______________________________ School____________________________________ Church______________________________________________ Other (please explain) _____________________________________________________________________________

REFERENCES (See (2) attached reference letters) Please provide two (2) persons who can comment on your ability to volunteer on the attached reference letters; one personal/character reference and one school/teacher reference. Both references should not be a relative. The attached letter and questionnaire will be sent to these persons, indicating you have given us permission to contact them. Complete mailing address for each reference is required for application to be processed. CRIMINAL BACKGROUND INFORMATION Have you ever pled guilty, pled no contest or been convicted of any criminal offense (misdemeanor or felony) other than parking tickets? ___ Yes ___ No If you answered yes, please provide complete information on all criminal offense(s), date(s), location(s), (city/county and state) and disposition. (use additional sheet if necessary): Offense Date Location Disposition

EMERGENCY CONTACT INFORMATION Person to notify in case of an emergency:_____________________________________________________________ Phone:_____________________________________________Relationship:_________________________________ APPLICATION VERIFICATION STATEMENT I certify that the information given on this application and in any other supporting documentation is true and correct. I understand that any false information and/or willful or negligent failure to disclose any requested information will constitute sufficient grounds to terminate my volunteer status without notice. I also understand that as a volunteer I am asked to dedicate 2-4 hours for at least 6 months. _________________________________________________ Applicant Signature Date PARENTAL CONSENT My son/daughter has my permission to serve as a Junior Volunteer at Adventist GlenOaks Hospital. I acknowledge that I must attend the Personal Interview with my son/daughter. I grant my permission for TB testing. I understand that in an emergency you will try to reach me. If this is not possible, you may have my permission to take whatever steps are necessary to safeguard my childs health and welfare. _________________________________________________ Parental Signature Date __________________________________________ Printed Name of Parent __________________________________________ Printed Name of Applicant

Please mail or drop off completed application to: Stephanie Murrill Volunteer Services Adventist GlenOaks Hospital 701 Winthrop Avenue Glendale Heights, IL 60139

Date:________________________ Name and Address of Reference (Highlighted areas to be filled out by applicant):

_____________________________________________________________ _____________________________________________________________ _____________________________________________________________


I have applied to become a volunteer at Adventist GlenOaks Hospital. The position requires a reliable individual that represents the standards and values of Adventist GlenOaks Hospital. I have included your name as a reference and would greatly appreciate your prompt assistance in this process. Please answer the questions below. All information will be regarded as confidential. Please return in the envelope provided at your earliest convenience. You may also fax to the attention of Volunteer Services at (630)545-3920. For any questions, please call (630)545-4992 or email stephanie.murrill@ahss.org. Thank you in advance for your willingness to serve as my reference.
____________________________________________ Signature of Applicant ___________________________________________ Applicants Printed Name

VOLUNTEER APPLICANT: 1. 2.

__________________________________________________

How long have you known the applicant? ________________________ What is the capacity in which you know the applicant?

______________________________________________________________________________________________________ ______________________________________________________________________________________________________ 3. 4. 5. Is the applicant reliable and dependable? ________________ Would the applicant be a good representation of Adventist GlenOaks Hospital?___________________ Please share any additional information that would assist us in our decision.

______________________________________________________________________________________________________ ______________________________________________________________________________________________________ _________________________________ Signature of Reference/Date


If you are willing to let us contact you for any further questions about the applicant, please list your phone number and/or email address. Phone Number (_________)___________________________ Email Address__________________________________

Date:________________________ Name and Address of Reference (Highlighted areas to be filled out by applicant):

_____________________________________________________________ _____________________________________________________________ _____________________________________________________________


I have applied to become a volunteer at Adventist GlenOaks Hospital. The position requires a reliable individual that represents the standards and values of Adventist GlenOaks Hospital. I have included your name as a reference and would greatly appreciate your prompt assistance in this process. Please answer the questions below. All information will be regarded as confidential. Please return in the envelope provided at your earliest convenience. You may also fax to the attention of Volunteer Services at (630)545-3920. For any questions, please call (630)545-4992 or email stephanie.murrill@ahss.org. Thank you in advance for your willingness to serve as my reference.
____________________________________________ Signature of Applicant ___________________________________________ Applicants Printed Name

VOLUNTEER APPLICANT: 1. 2.

__________________________________________________

How long have you known the applicant? ________________________ What is the capacity in which you know the applicant?

______________________________________________________________________________________________________ ______________________________________________________________________________________________________ 3. 4. 6. Is the applicant reliable and dependable? ________________ Would the applicant be a good representation of Adventist GlenOaks Hospital?___________________ Please share any additional information that would assist us in our decision.

______________________________________________________________________________________________________ ______________________________________________________________________________________________________ _________________________________ Signature of Reference/Date


If you are willing to let us contact you for any further questions about the applicant, please list your phone number and/or email address. Phone Number (_________)___________________________ Email Address__________________________________

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