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Medical Director, Dr. William Ferri, Oncology/Hematology who oversees patient care and presides over team meetings. When necessary, the Medical Director serves as the liaison with the patient’s referring physician with regard to terminal care.

Patient’s Referring Physician who continues to direct and approve medical care. The hospice team consults with and maintains a relationship with the patient’s personal physician.

Registered and Licensed Practical Nurses who educate the patient and family with regard to the disease and its progression. They comfort patients and provide professional care to manage symptoms and ease pain while helping the patient to maintain the ability of living life to its fullest.

Certified Home Health Aides who gently and lovingly offer personal care assistance while preserving each patient’s dignity.

Medical Social Workers who understand the special needs of patients and their caregivers facing a life-limiting illness. They assist in many ways including coordination of community resources.

A Chaplain who respects each patient’s spiritual preferences and honors all denominations. The chaplain listens with an open heart, helps the patient along their journey, and allows them to choose their own spiritual path.

Trained Volunteers who genuinely share their kindness, gifts, and talents by helping patients and their families with everyday routine tasks while offering their time for loved ones to take a break from their caregiver role.

Bereavement Counselors who support loved ones in the grief work and help them to find healthy ways of coping. Bereavement services continue for at least one year after the loss of a loved one.

The goal is to keep the patient comfortable while enhancing the daily quality of life.

In addition to the team, Medicare law requires the hospice to provide medications directly related to the patient’s admitting diagnosis as well as durable medical equipment and soft good supplies as necessary.

On-call nursing for emergencies and additional support is offered 24 hours daily, 7 days a week.

Date of Application:

Name:

DOB:

Email:

Home Phone:

Cell Phone:

May we contact you at work? YesNo

Hours that you work:

Total Number of hours per week you could be available for hospice volunteering?

How many days per week?

Employment: Pleas list your employer(s) for the past five years

Languages spoken other than English and Fluency Level:

Education/Special Training skills/work experience: Please list any items which may be helpful in your volunteer role , i.e. Certification, Hobbies, Administrative skills, ETC

Personal Information:
Do you have volunteer Experience? Please Specify:

How did you learn about catholic hospice?

What inspires you to join the Catholic Hospice team?

Are you comfortable working with someone of a different religious faith than you? YesNo

Are you able to work with someone who practices a different lifestyle than you? YesNo

Are you willing to provide transportation for Patient/Family if needed? YesNo

Are there any special circumstances relating to your health that we should consider when assigning you to a patient? YesNo
If yes, Please Explain

Have you Experienced the loss of a loved one -Friend or Family? YesNo
If yes, when did this occur?

How did this person's death affect you?

Volunteer Oportunities
Please indicate your volunteer area of interest(s)
Patient CareBereavement VisitationBereavement Telephone ContactBereavement MailingsClericalFund RaisingPublic Relations

Professional Consultation (Specify area of expertise)

Other Please Specify

References
Please list three personal references (no relatives) whom you have known for at least one year.
Name/Address/Telephone#

The information provided in the application process will assist us in determining appropriate volunteer assignments. The Catholic Hospice team is committed to making your experience rewarding and beneficial to the community which we serve. Thank you for your interest in volunteer opportunities with Catholic Hospice.