Thank you for your interest in volunteering at Centerpoint!

Please complete and submit this application to Sarah Peterson, HR Manager. Once the application is received there will be an interview to determine if there are current openings in areas which appear to match your interests and availability. If accepted to volunteer service, applicants are required to: (1) complete a lab screening for tuberculosis and titers: paid for by the hospital, (2) have a background check: paid for by the hospital, and (3) complete 1 day of hospital orientation. All volunteers are asked for at least a 4 hour a week volunteering commitment.

All fields with an asterisk (*) are required.

Thank You

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2022-MID-Centerpoint Medical Center-Volunteer Application-PHI

Applicant information

Are you at least 18 years of age?
Birth Date

Education and experience

Currently or plan to be a student in college/nursing program?
Have you ever been convicted of a crime?
I have volunteered at Centerpoint, Independence Regional, or Medical Center of Independence previously:

Previous volunteer experience:


Available time for volunteering (please check all time that apply)

Applicant acknowledgment

I certify that the information given by me in this application is true and complete. I hereby authorize all individuals and organizations named or referred to in this application to give Centerpoint Medical Center all information relative to my possible volunteer assignment and work habits. I hereby release such individuals, organizations and Centerpoint Medical Center from any liability for any claim, damage, which may result. I understand that I will not be paid for time volunteering at Centerpoint.

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