HR Volunteer Request Form

Name*

First Last

I would like to:*

Hire a volunteer

Anticipated Start Date*

Anticipated End Date*

Who is the faculty supervisor for this position?*

In which room will the volunteer be housed?*

Will the employee have Patient Contact or contact with Bloodborne Pathogens?*

Patient Contact
Bloodborne Pathogens
No
Not Sure

Employees having contact with patients or with human blood will require a health assessment and/or additional training. Please review the descriptions for Patient Contact and Contact with Human Blood and select any that are applicable below.

Where will the patient contact take place?*

MBI, CLC, etc.

Name of volunteer?*

First Last

Gatorlink Username of Volunteer:*

Volunteer's Email Address:*

Please upload the Emergency Contact Form:

Accepted file types: acceptedfiletypes:jpg, pdf, png, doc, docx, Max. file size: 125 MB.

Please confirm that the volunteer has completed the following trainings*

HIPAA - General Awareness, PRV800
Compliance: A Collaboration for Success! OOC101
Maintaining a Safe and Respectful Campus GET803
Confidentiality Statement & Health Information Policy

IT Access will not be granted until all of the below have been completed. Please check the Training Tracker for instructions and to see if additional training is needed.

IT Access:*

P Drive
N/A

Please check any access the employee will require.

Please list shared folder(s):

Please fill out the form below.

HR Volunteer Form