Triad Health Project Volunteer Information Form and Confidentiality Statement

Triad Health Project Volunteer Information Form and Confidentiality Statement
PLEASE NOTE - WE ARE GRATEFUL TO HAVE MANY TERRIFIC VOLUNTEERS FOR ALL OF OUR ROUTINE ROLES WHO STICK WITH US FOR LONG PERIODS OF TIME. THIS ALSO MEANS THAT WE DO NOT OFTEN HAVE IMMEDIATE NEEDS FOR NEW VOLUNTEERS. PLEASE KNOW THAT IF WE DO NOT HAVE A CURRENT OPENING, WE WILL BE HAPPY TO KEEP YOUR INFORMATION ON FILE SHOULD ONE ARISE. THANK YOU FOR YOUR UNDERSTANDING AND PATIENCE. Thank you for your interest in volunteering with Triad Health Project! Volunteers play an essential role in helping THP effectively carry out its mission in this community. With the exception of HIV/STD testing on Monday nights and helping with special events, nearly all volunteer activities occur during our normal business hours, Monday-Friday from 8:30AM-5:00PM. Please help us maintain up-to-date information on our volunteers by completing the following form. This information must be collected before you can volunteer with THP.
Last Name
First Name
Middle Initial
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Telephone
Primary Phone Type
Secondary Telephone
E-Mail Address
Best Method to Contact
Date of Birth

MonthDayYear
Driver's License Number
Driver's License - Issuing State
Employer
Job Title
Students - School Name
Students - Class Year
Emergency Contact Person
Emergency Contact - Relation to Self
Emergency Contact - Phone Number
Most of THP's volunteer opportunities occur during business hours, M-Th from 8:30AM-5:00PM. On Mondays, we do utilize volunteers to help with HIV testing from 5:00-7:00PM in the Greensboro office. Special events sometimes necessitate the need for weekend volunteer support.
Availability - Days
Availability - Times
Other Comments about Availability
Do you have access to your own personal vehicle?
Vehicle Type
Areas of Volunteer Interest
Other Interests:
Additional Comments - Volunteer Interest
Special Needs / Limitations / Special Considerations as a Volunteer
Special degrees, courses, training, or experience that you have that will benefit your volunteer work with THP
Have you ever been convicted of a felony?
Confidentiality is paramount to THP and its clients. THP volunteers are responsible for maintaining the confidentiality of all proprietary information to which they are exposed to as a volunteer. Volunteers must treat any of the following information about THP clients as strictly confidential:

Name, HIV/STI status, sexual orientation, financial status, occupation, place of employment, home or work address, substance use issues, make or model of automobile, medical status or treatments
Confidentiality Attestation
PLEASE NOTE: We often receive more volunteer requests than we can immediately fill. Please be patient with us. In the event we do not have an immediate opening, we will keep your form on file and contact you should an opening occur that is aligned with our needs and your interests and availability. Thank you!
Should be Empty:

Triad Health Project Volunteer Information Form and Confidentiality Statement

Most of THP's volunteer opportunities occur during business hours, M-Th from 8:30AM-5:00PM. On Mondays, we do utilize volunteers to help with HIV testing from 5:00-7:00PM in the Greensboro office. Special events sometimes necessitate the need for weekend volunteer support.

Confidentiality is paramount to THP and its clients. THP volunteers are responsible for maintaining the confidentiality of all proprietary information to which they are exposed to as a volunteer. Volunteers must treat any of the following information about THP clients as strictly confidential: