Pet Therapy Team Volunteer Application

Thank you for your interest in volunteering at UCHealth Highlands Ranch Hospital with our pet therapy program! Therapy animals and their handlers play an important and meaningful role in providing extraordinary care to our patients and their families. We hope you find your experience here to be valuable and worthwhile.

Following submission of this form, you will be contacted to schedule an interview here at the hospital with your therapy dog.When submitting your application, please upload copies of the following:

1) Proof of current membership in an organization that provides national certification including, but not limited to:

Therapy Dogs International
Pet Partners
Alliance of Therapy Dogs (ATD)
Go Team

2) Proof of current rabies vaccination.

3) Current health certificate with a vaccination list from your veterinarian.

We look forward to meeting you! If you have any questions, please contact us at HRHvolunteers@uchealth.org.

Onboarding Process

Step One: Complete the volunteer application below.

Step Two: Notify your references that they will receive an email request for a reference.

Step Three: Review the UCHealth Volunteer Handbook and complete volunteer paperwork through our online portal

Step Four: Attend an interview with your therapy dog.

Step Five: Complete a Health Screen.

All volunteers are required to have the following vaccines: MMR, Varicella, Hepatitis B, Tdap, Influenza during flu season, and a negative TB test within the last year. If you do not hav eyour immunization records or are missing immunizations, UCHealth will provide titer tests and assist you in fulfilling the required immunizations.

Step Six: Complete a background check.

Step Seven: Complete the UCHealth orientation training modules (virtual).

Step Eight: Sign-up for a shadow-shift with another pet therapy volunteer; receive your Volunteer Badge & Vest.

Step Nine: Start Volunteering!

We look forward to meeting you! If you have any questions, please contact us at HRHvolunteers@uchealth.org.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Contact Information

* First name

Middle initial

* Last Name

Preferred Name if different from First Name:

Preferred Pronouns

* Address:

Apartment #

* City:

* State

* Zip code:

* DOB

* E-mail:

* Cell Phone

Home Phone

Work Phone:

What is the best way to contact you?

* Last 4 Digits of SSN

* Please upload a photo of yourself (you're welcome to include your dog, too!). We'll share this with the unit(s) you'll be visiting so staff can look forward to welcoming you  

Emergency Contact

Please provide the name and number of someone we may contact in case of an emergency.

* Name:

* Phone:

* Relationship

Employment Status

Select your Employement Status:

Current Employer

Current Position/Title

Education

Highest level of education completed

College/University Name:

Degree/Major:

How did you hear about volunteering at UCHealth?

Availability

Select times when you are available to volunteer: (You may select more than one.)

To expedite the interview process, please answer the following questions

* Why do you wish to volunteer at UCHealth?

* What previous volunteer experiences do you have, what challenges did you meet and how did you make a difference for others?

* Tell about a time in your work life or volunteer life when you worked on a team. What role did you play and why?

* What are your three greatest accomplishments in your life so far?

* What special, wonderful and unique qualities will you bring to make a difference for our patients?

About Your Therapy Dog

* What is your Therapy Dog's name?

* Date of Birth (Mo/Yr)

* Breed

What organization is your therapy dog certified through?

* Therapy dog certification

* Rabies

* Health Certificate

REFERENCE INFORMATION

PLEASE NOTE: A VOLUNTEER REFERENCE REQUEST WILL BE SENT TO THE CONTACTS PROVIDED.

REFERENCE 1

* Name

* Organization name or relationship to applicant

* E-mail

REFERNCE 2

* Name

* Organization name or relationship to applicant

* E-mail

APPLICANT E-SIGNATURE

I acknowledge that I am volunteering of my own free will and do not expect any monetary reimbursement. I verify that the information provided is accurate to the best of my knowledge. I authorize UCHealth -Metro Denver and its agents to confirm all information provided on the application.

* Therapy Team Handler Applicant - please type your name in this field as a form of electronic signature

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.

* Therapy Team Handler Applicant - please type your name in this field as a form of electronic signature

* Date: