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Terms & Conditions
By Clicking "Submit Application" I hereby authorize Family Health West to contact me and my listed references and use the information entered on this form for the Volunteer Application process and file/information storing.
I understand that a condition of volunteering at Family Health West is a screening test for tuberculosis. Upon completion of the volunteer interview and initial volunteer onboarding process, it is the responsibility of the volunteer or the parent of the volunteen to contact the TB Nurse at 970-858-2190 to schedule their TB test, the follow-up visit, the second TB test and the second follow up visit.
If the results of this test are positive, I understand that a chest x-ray will be done. Family Health West agrees to do the screen and/or x-ray free of charge.
I acknowledge that I will also be required to complete a drug screening prior to volunteer service. Family Health West is determined to eliminate the use of illegal drugs, alcohol, and controlled substances. This program is designed solely for the benefit of volunteers and employees, to provide reasonable safety while on duty, and to protect them and patients/residents from offending individuals. Additionally, this program meets Family Health West's commitment to the community it serves.
All volunteers are required to have a flu shot (October - March) and COVID vaccine per the state guidelines.
Submitting an application will act as my authorization signature or that of a parent or guardian who agrees to the above.
I agree that a facsimile (fax), electronic or photographic copy of this Authorization shall be valid as the original.
I Agree
By Clicking "Submit Application" I hereby authorize Family Health West to contact me and my listed references and use the information entered on this form for the Volunteer Application process and file/information storing.
I understand that a condition of volunteering at Family Health West is a screening test for tuberculosis. Upon completion of the volunteer interview and initial volunteer onboarding process, it is the responsibility of the volunteer or the parent of the volunteen to contact the TB Nurse at 970-858-2190 to schedule their TB test, the follow-up visit, the second TB test and the second follow up visit.
If the results of this test are positive, I understand that a chest x-ray will be done. Family Health West agrees to do the screen and/or x-ray free of charge.
I acknowledge that I will also be required to complete a drug screening prior to volunteer service. Family Health West is determined to eliminate the use of illegal drugs, alcohol, and controlled substances. This program is designed solely for the benefit of volunteers and employees, to provide reasonable safety while on duty, and to protect them and patients/residents from offending individuals. Additionally, this program meets Family Health West's commitment to the community it serves.
All volunteers are required to have a flu shot (October - March) and COVID vaccine per the state guidelines.
Submitting an application will act as my authorization signature or that of a parent or guardian who agrees to the above.
I agree that a facsimile (fax), electronic or photographic copy of this Authorization shall be valid as the original.
I Agree
Check here to show you accept the terms stated above for yourself or for a minor for which you are the parent or legal guardian.
