Volunteer Application

  • Patient CareProgram
  • YesNo
  • In order to assure proper placement of all volunteer, we do request that you answer the following question: Do you have a disability which might affect your performance or create a hazard to yourslef or to others in connection with the job for which you are applying? If so, please state the following: (1) Skills and procedure you use or intend to use to perform the job notwithstanding the disability , and (2) accomodations we could make which would enable you to perform the job properly and safely, including special equipment, change sin physical layout if the job, elimination of certain duties relating to the job or other accomodations.

  • YesNo
  • YesNo
  • YesNo
  • YesNo
  • DaysEveningsWeekends

The Joint Commission organization certification ID number: 531243

Get In Touch

310-205-2587 310-362-8805

2140 West Olympic Boulevard, Suite 326
Los Angeles, CA. 90006